Introduction: Immunosuppression therapy is essential to avoid rejection after kidney transplantation. The chronic use of this drugs increases the risk of malignancy compared to general population. Oncology complications are a main cause of recipient death. The increase the knowledge about the prevalence and risk factors could decrease the incidence and implement screening protocols for an early diagnosis.

Material and methods: We compared the incident of non-cutaneous cancers after 10 years of follow-up in three cohorts of kidney transplantations: Group A non-induction antibodies therapy, Group B received thymoglobulin and Group C received antiCD25. We performed a Kaplan Meier survival curves freedom of neoplasm in the three different groups. We analysed risk factors associated with the development of neoplasm.

Results: Of the 474 kidney transplantations, 9% (43) had a non-cutaneous neoplasm after 10 years of follow up. The neoplasms were: 9 kidney-urinary tract malignancies, 9 gynecologic, 5 prostate, 5 haematological, 3 gastrointestinal, 3 lung, 2 otorhinolaryngology and 7 others. The basal characteristics were similar between the groups, but Group A had more acute rejection (29.3% vs 13.6% vs 25%, p=0.001). There isn't any difference between the groups in the survival free-neoplasm (p>0.05). The multivariate analysis shown that recipient age > 55 years (HR: 2.4 [CI 1.3-4.5, p=0.006]), previous hemodialysis as renal replacement therapy (HR: 1.9 [CI 0.96-3.7, p=0.06]) and previous neoplasm (HR: 4.1 [CI 1.8-9.3, p=0.001]) were the main factors to develop a neoplasm after kidney transplantation. 33 patients died after 10 years of the follow up, the main causes of deaths were cardiovascular (48.5%) and neoplasm (36.4%) causes.

Conclusions: The main non-cutaneous neoplasm were related with urinary tract, gynecologic and haematological. The age older than 55 years old, previous hemodialysis renal replacement therapy and previous neoplasm were the factors related with a develop of a neoplasm after kidney transplantation. We didn't find any relationship with immunosuppression induction therapy. Oncology cause was the second cause of death in our cohort. The introduction of a neoplasm screening programme after kidney transplantation could decrease the incidence of tumor and increase recipient survival.

CITATION INFORMATION: Molina M., Cabrera J., Gonzalez E., Hernández A., Polanco N., Andres A. Malignancy Complications after Kidney Transplantation, the Role of Immunosuppression Am J Transplant. 2017;17 (suppl 3).

« Back to 2018 American Transplant Congress