Malignancy Incidence after Pediatric Kidney Transplantation; a Single-Center Experience in Japan
1Urology and Kidney Transplantation, Tokyo Metropolitan Children’s Medical Center, Tokyo, Japan, 2Nephrology, Tokyo Metropolitan Children’s Medical Center, Tokyo, Japan, 3Nephrology, Toho University, Faculty of Medicine, Tokyo, Japan
Meeting: 2020 American Transplant Congress
Abstract number: A-063
Keywords: Kidney transplantation, Malignancy, Pediatric, Post-transplant lymphoproliferative disorder (PTLD)
Session Information
Session Name: Poster Session A: Kidney: Pediatrics
Session Type: Poster Session
Date: Saturday, May 30, 2020
Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
Location: Virtual
*Purpose: The incidence of malignancy was higher in organ transplant recipients than in the general population, and malignancies are a well-recognized complication of organ transplantation. The aim of this study was to investigate the incidence and type of malignancy after pediatric kidney transplantation over the past three decades.
*Methods: We performed a retrospective cohort study on pediatric kidney transplant recipients, aged 18 years or younger, who received their first transplant between January 1975 and December 2009 at our hospital. Recipients were followed from kidney transplantation until the last known date alive of December 2016, and clinical data were extracted from the medical records.
*Results: Among the 375 children who underwent kidney transplantation during the study period, 21 (5.6%) developed malignancy. The median duration of follow-up was 15.3 years (range 0.0-42.2), and the median age of the survivors at last follow-up was 26.3 years (range 8.7-57.6). The cumulative incidence of cancer was 0.8, 2.5, 2.8, 4.2%, 5.5% and 15.6% at 1, 5, 10, 15, 20 and 30 years post-transplantation, respectively. Of the 375 patients, nine patients (2.4%) had a lymphoproliferative malignancy, and 12 patients (3.2%) had a non-lymphoproliferative malignancy. The median age of the first malignancy was 21.3 years (range 3.4-45.3). The median time from transplant to diagnosis was 2.2 years (IQR 0.6-2.8) for lymphoproliferative malignancies and 22.3 years (IQR 12.3-26.6) for non-lymphoproliferative malignancies. During the follow-up, five recipients died as a result of malignancy. The cause of death was hepatocellular carcinoma in one patient, squamous cell carcinoma in the transplantation kidney in one patient, malignant schwannoma in one patient, and EBV-related lymphoma in two patients. The mortality rate was 0.79 per 1000 person-years (95% CI 0.38, 1.85).
*Conclusions: Early diagnosis and treatment of malignancy in transplant recipients is an important challenge. Therefore, we should show enhanced surveillance and continued vigilance for malignancy following renal replacement therapy.
To cite this abstract in AMA style:
Aoki Y, Satoh H, Hamada R, Harada R, Muramatsu M, Hamasaki Y, Shishido S. Malignancy Incidence after Pediatric Kidney Transplantation; a Single-Center Experience in Japan [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/malignancy-incidence-after-pediatric-kidney-transplantation-a-single-center-experience-in-japan/. Accessed October 30, 2024.« Back to 2020 American Transplant Congress