Comparative Analysis of Risk Factors and Outcomes in Kidney Transplant Recipients with Lung Cancer and Those with No Malignancy: UNOS Data Set
1Transplant Nephrology, Beth Israel Deaconess Medical Center, Boston, MA, 2Department of Internal Medicine, Metrowest Medical Center, Boston, MA
Meeting: 2020 American Transplant Congress
Abstract number: B-208
Keywords: Graft survival, Kidney transplantation, Lung, Malignancy
Session Information
Session Name: Poster Session B: PTLD/Malignancies: All Topics
Session Type: Poster Session
Date: Saturday, May 30, 2020
Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
Location: Virtual
*Purpose: Transplant recipients are at increased risk for malignancy. Patients who develop cancer after transplant have worse outcomes, especially those with lung cancer. Transplant-related risk factors for lung cancer have not been previously studied in literature. We reviewed the United Network of Organ Sharing (UNOS) registry and identified patients who developed lung cancer after kidney transplantation.
*Methods: UNOS registry was reviewed and kidney transplant recipients who underwent transplantation between January 2000 and December 2018 were identified. Patients with other malignancies apart from lung cancer were excluded. The baseline characteristics of donor and recipients were compared using Chi-square or Kruskal-Wallis test. Kaplan-Meier curve was used to measure graft survival time.
*Results: 274,684 patients were included. 1,919 patients developed lung cancer and 272,765 patients did not develop any malignancies after transplantation.Compared to patients without malignancy, risk of lung cancer is associated with older age (60 vs. 50 year-old, P<0.001), male gender (65.8 vs. 60%, P<0.001), white race (73.1 vs. 50.5%, P<0.001), expanded criteria donor (ECD) (22.6 vs. 14.9%, P<0.001), and maintenance immunosuppression with cyclosporine (16.5 vs. 11%, P<0.001).Mortality rate among patients with lung cancer is 84% at a median follow-up of 5.6 [3.2-8.4] years after transplant. Lung cancer was diagnosed 1,772 (931-2842) days after transplant. Death censored graft survival time after diagnosis of lung cancer was 161 days.
*Conclusions: The majority of kidney transplant patients who develop lung cancer are diagnosed between 2 and 7 years after transplant. Lung malignancy is associated with very poor patient survival, and a median graft survival of only 5 months after diagnosis. Risk factors include older age, male gender, white race, ECD, and cyclosporine use. These transplant-related characteristics, in association with other established risk factors for lung cancer, should increase awareness of transplant physicians.
To cite this abstract in AMA style:
Patel H, Nissaisorakarn V, Karrecci ESula, Agrawal N, Cardarelli F. Comparative Analysis of Risk Factors and Outcomes in Kidney Transplant Recipients with Lung Cancer and Those with No Malignancy: UNOS Data Set [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/comparative-analysis-of-risk-factors-and-outcomes-in-kidney-transplant-recipients-with-lung-cancer-and-those-with-no-malignancy-unos-data-set/. Accessed May 11, 2025.« Back to 2020 American Transplant Congress