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Post-Kidney Transplant Cancer: A Real-World Retrospective Analysis From a Single Italian Center.

Authors :
Sartò, Giulia Vanessa Re
Alfieri, Carlo
Cosmai, Laura
Brigati, Emilietta
Campise, Mariarosaria
Regalia, Anna
Verdesca, Simona
Molinari, Paolo
Pisacreta, Anna Maria
Pirovano, Marta
Nardelli, Luca
Gallieni, Maurizio
Castellano, Giuseppe
Source :
Transplant International; 2024, p1-10, 10p
Publication Year :
2024

Abstract

We describe the epidemiology of cancer after kidney transplantation (KTx), investigating its risk factors and impact on therapeutic management and survival in KTx recipients (KTRs). The association between modification of immunosuppressive (IS) therapy after cancer and survival outcomes was analyzed. We collected data from 930 KTRs followed for 7 [1--19] years. The majority of KTRs received KTx from a deceased donor (84%). In total, 74% of patients received induction therapy with basiliximab and 26% with ATG. Maintenance therapy included steroids, calcineurin inhibitors, and mycophenolate. Patients with at least one cancer (CA+) amounted to 19%. NMSC was the most common tumor (55%). CA+ were older and had a higher BMI. Vasculitis and ADPKD were more prevalent in CA+. ATG was independently associated with CA+ and was related to earlier cancer development in survival and competing risk analyses (p = 0.01 and <0.0001; basiliximab 89 ± 4 vs. ATG 40 ± 4 months). After cancer diagnosis, a significant prognostic impact was derived from the shift to mTOR inhibitors compared to a definitive IS drug suspension (p = 0.004). Our data confirm the relevance of cancer as a complication in KTRs with ATG as an independent risk factor. An individualized choice of IS to be proposed at the time of KTx is crucial in the prevention of neoplastic risk. Finally, switching to mTORi could represent an important strategy to improve patient survival. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
09340874
Database :
Complementary Index
Journal :
Transplant International
Publication Type :
Academic Journal
Accession number :
179411442
Full Text :
https://doi.org/10.3389/ti.2024.13220