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There is a paucity of studies describing malignancy-related mortality after kidney transplantation. To help quantify this, we extracted data for all kidney-alone transplant procedures performed in England between April 2001 and March 2012. Data linkage analysis was performed between Hospital Episode Statistics and the Office for National Statistics to identify all deaths occurring in this cohort. Among 19,103 kidney transplant procedures analyzed (median follow-up 4.4 years), 2085 deaths occurred, of which 376 (18.0%) were due to malignancy (crude mortality rate 361 malignancy-related deaths per 100,000 person-years). Common sites of malignancy-related death were lymphoma (18.4%), followed by lung (17.6%) and renal (9.8%), with 14.1% unspecified. The risk of malignancy-related death increased with age: under 50 (0.8%), 50-59 (2.5%), 60-69 (4.8%), 70-79 (6.5%) and over 80 years (9.1%). Age- and gender-stratified malignancy-related mortality risk difference was higher in the transplant compared with the general population. Cox proportional hazard models identified increased age, pretransplant history of malignancy and deceased-donor kidney transplantation to be independently associated with risk for post-transplant death from malignancy. Thus, malignancy as a cause of post-kidney transplantation death is common and requires heightened surveillance.

Background: The aim of this study was to explore age-related mortality post-kidney transplantation in England over the last decade., Methods: This study used data from Hospital Episode Statistics to select all kidney transplant procedures performed in England between April 2001 and March 2012. Demographics and medical comorbidities (based upon ICD-10 codes) were extracted at baseline. Data linkage analysis was performed with the Office for National Statistics to identify all deaths occurring among this study cohort., Results: Data for 19,103 kidney transplant procedures was analyzed, with a median follow-up of 4.4 years (interquartile range 2.2-7.3 years). Categorization of age cohorts at time of transplantation were age below 50 (n=11,421, 59.8%), 50 to 59 (n=4,195, 22.0%), 60 to 69 (n=2,887, 15.1%), 70 to 79 (n=589, 3.1%), and 80 and above (n=11, 0.1%). There were 2,085 deaths that occurred among the study cohort during follow-up and mortality risk increased with age: below 50 (5.8%), 50 to 59 (14.2%), 60 to 69 (22.0%), 70 to 79 (31.9%), and 80 and above (45.5%). The three most common causes of deaths for recipients 70 and over were cardiac (21.2%), infection (21.2%), and malignancy (20.2%), respectively. Lower mortality was observed with the receipt of a living-donor kidney for recipients aged 70 and above. On Cox regression analysis, risk for death increased with each additional decade of recipient age over 50., Conclusion: Increasing age is a strong, independent risk factor for death after kidney transplantation. Although lower mortality was observed with living kidney transplantation among elderly recipients, living-donor rates decrease with increasing recipient age. Pretransplant counseling and posttransplant tailored immunosuppression should be explored, the latter requiring targeted clinical trials.

The risk of death within the first year postkidney transplantation is not well described in the contemporary era. We extracted data on all kidney transplant procedures performed in England between April 2001 and March 2012. Data linkage analysis was performed between Hospital Episode Statistics and the Office for National Statistics to identify all deaths. Cox proportional hazard models were performed to identify factors associated with 1-year mortality. 566 deaths (3.0%) occurred within the first year post-transplant (from 19,103 kidney transplant procedures analysed). Infection, cardiovascular events and malignancy were classified in 21.6%, 18.3% and 7.4% of death certificates, respectively. Among recipients with prior myocardial infarct history who died within the first year, 38.8% of deaths were attributed to a cardiac-related event. Malignancy-related death was responsible for 61.5% of 1-year mortality for allograft recipients with pretransplant cancer history. 22.1% of deaths included kidney failure as a contributory factor on the death certificate (3.3% specifically stated allograft failure). Variables associated with 1-year mortality included deceased-donor kidney, increasing age, residence in socioeconomically deprived area and history of select medical comorbidities pre-operatively. We conclude 1-year mortality postkidney transplantation is low, but in select allograft recipients, the risk of death increases considerably., (© 2013 Steunstichting ESOT.)

The aim of this study was to explore mortality after pediatric kidney transplantation in England over the last decade. We used data from HES to select all kidney transplant procedures performed in England between April 2001 and March 2012. Data linkage analysis was performed with the ONS to identify all deaths occurring among this study cohort. Data for 1189 pediatric recipients were compared to 17 914 adult recipients (number of deaths, 33 vs. 2052, respectively, p < 0.001), with median follow-up 4.4 yr (interquartile range 2.2-7.3 yr). There was no difference in mortality within the pediatric cohort; age 0-1 (n = 25, patient survival 100.0%), age 2-5 (n = 198, patient survival 96.0%), age 6-12 (n = 359, patient survival 97.5%), and age 13-18 (n = 607, patient survival 97.4%), respectively (p = 0.567). The most common causes of death were renal (n = 8, 24.2%), infection (n = 6, 18.2%), and malignancy (n = 5, 15.2%). All deaths from malignancy were secondary to PTLD. In a fully adjusted Cox regression model, only white ethnicity was significantly associated with risk of pediatric mortality post-kidney transplantation (hazard ratio 2.7, 95% confidence interval [1.0-7.3], p = 0.047). To conclude, this population-based cohort study confirms low mortality after pediatric kidney transplantation with short follow-up., (© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

With most surname research undertaken within the fields of anthropology and population genetics, geographers have overlooked surnames as a credible data source. In addition to providing a review of recent developments in surname analysis, this paper highlights areas where geographers can make important contributions to advancing surname research, both in terms of its quality and also its applications. The review discusses the emerging applications for surname research, not least in the mining of online data, and ends by suggesting three future research themes to ensure the building momentum of surname research continues to grow across disciplines.