Background: Previous studies have shown increased incidence of malignancies in patients after kidney transplantation. However, most of the existing data on post-transplant malignancies is limited due to small sample sizes, short follow-up intervals, focus on only one specific cancer entity or lack of information on cancer-specific mortality rates.

Methods: In this retrospective study all adult kidney transplant recipients (KTR) (n=1417) that underwent first kidney transplantation between 1995 to 2016 at our center were screened for development of de novo malignancies. All post-transplant malignancies were identified using the electronical patient records of our outpatient clinic, the clinical information system of the Charité Universital Hospital and the database of the cancer registry of the Charité Comprehensive Cancer Center. KTR with nonmelanoma skin cancer (n=64) were excluded from the analysis.

Results: Overall 179 malignancies were detected in 154 KTR (11%). Mean age at time of development of malignancies was 60.4±13.4 years. 23 KTR developed multiple malignancies. n=16 (1%) of the malignancies were detected after KTR had returned to maintenance dialysis due to graft failure. Frequency and type of malignancies are shown in Fig. 1A.

KTR who developed malignancies were significantly older at time of transplantation (54.5±13.9y vs. 49.3±14.8y; p<0.001), more frequently male (70% vs.60%; p=0.014), received more frequently a deceased donation (77% vs. 66%; p= 0.008) and had more often repeated kidney transplantations (8% vs.3%; p=0.008) compared to KTR without malignancies. Donor age (53.4±15.5y vs. 52.7±14.7; p=0.586), HLA mismatches (2.8±1.7 vs. 2.7±1.7; p=0.658) and time on dialysis (median 49 (27-74) vs. 43 (17-77) months; p=0.212) did not differ significantly between the groups. Mean observation period was 9.8 (5.1) vs. 8.0 (5.3); p<0.001. Patient survival rates after diagnosis of specific cancer is shown in Fig. 1B.

Conclusions: Strategies for vigilant screening for malignancies are needed in order to improve transplant outcomes in the future.

CITATION INFORMATION: Khadzhynov D., Halleck F., Froehlich F., Lehner L., Schrezenmeyer E., Budde K., Staeck O. Malignancies in Kidney Transplant Recipients: A Long-Term Observational Study Am J Transplant. 2017;17 (suppl 3).

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