Kidney Week

Abstract: SA-PO050

Exposure to a Functioning Kidney Transplant and Cancer Risks

Session Information

• Transplantation: Clinical Outcomes
  October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 1802 Transplantation: Clinical

Authors

• Au, Eric Hoi Kit, The University of Sydney, Sydney, New South Wales, Australia

Eric Hoi Kit Au,

• Chapman, Jeremy R., Westmead Hospital, Sydney, New South Wales, Australia

Jeremy R. Chapman,

• Teixeira-Pinto, Armando, The University of Sydney, Sydney, New South Wales, Australia

Armando Teixeira-Pinto,

• Craig, Jonathan C., The University of Sydney, Sydney, New South Wales, Australia

Jonathan C. Craig,

• Wong, Germaine, The University of Sydney, Sydney, New South Wales, Australia

Germaine Wong,

Background

Kidney transplant recipients experience higher cancer incidence and mortality compared to the general population. It is uncertain whether this increased risk varies with graft function. This study aims to compare the cancer incidence and mortality rates in transplant recipients during periods of graft function and graft failure with the age- and gender-matched general population.

Methods

All Australian patients who commenced renal replacement therapy between 1982 and 2014 were included from the Australia and New Zealand Dialysis and Transplant Registry. Cancer incidence and mortality for dialysis patients and transplant recipients during periods of graft function and graft failure were compared with the Australian general population using standardized incidence (SIR) and mortality (SMR) ratios.

Results

A total of 47,127 dialysis patients without transplants, 15,413 with 1^st transplants, 3873 after 1^st graft failure, 1596 and 545 with 2^nd transplants and 2^nd graft failure were identified and followed for 297,626 patient-years. The standardized incidence and mortality rates (per 100,000 patient-years) were 727 and 336 in dialysis patients; 1322 and 675 in recipients with 1^st transplants; 1017 and 367 after 1^st graft failure; 1531 and 870 for 2^nd transplants and 1434 and 880 after 2^nd graft failure. Cancer SIRs (95% CI) and SMRs (95% CI) were 1.2 (1.1-1.2) and 1.3 (1.2-1.4) for dialysis patients; 2.1 (2.0-2.2) and 2.6 (2.4-2.8) for recipients with 1^st transplant; 1.6 (1.4-1.9) and 1.4 (1.0-1.9) after 1^st graft failure; 2.4 (2.1-2.9) and 3.4 (2.6-4.2) for 2^nd transplants; 2.3 (1.5-3.4) and 3.4 (1.8-5.9) after 2^nd graft failure.

Conclusion

An increased cancer incidence and mortality risk is observed during periods with a functioning kidney transplant. Among patients with failed allografts, cancer incidence and mortality remained higher than the general population, but the increased risk appears lower than recipients with functioning grafts.

Funding

• Government Support - Non-U.S.