Outcome of Adult Kidney Transplant Candidates With Previous Malignancy: Analysis of 14-Year Waiting List Data in the United States
College of Medicine, Univ. of Florida, Gainesville, FL.
Meeting: 2015 American Transplant Congress
Abstract number: D226
Keywords: Malignancy, Outcome, Survival, Waiting lists
Session Information
Session Name: Poster Session D: PTLD/Malignancies: All Topics
Session Type: Poster Session
Date: Tuesday, May 5, 2015
Session Time: 5:30pm-6:30pm
Presentation Time: 5:30pm-6:30pm
Location: Exhibit Hall E
Purpose: We aimed to study the difference in patient survival and transplantation probability rates of adult kidney transplant (KT) candidates with and without history of malignancy present at transplant wait-listing.
Methods. We studied Scientific Registry of Transplant Recipients (SRTR) data of adults wait-listed for initial kidney transplant from 1999-2012. Qualified patients were assigned into cohorts with history of malignancy (Hx-Ca),(n=12,388), and without history of malignancy(No-Hx-Ca),(n=255,122). The 5-year waiting-list patient survival and kidney transplantation probabilities were analyzed using Kaplan-Meier models with log-rank tests, and factors associated with these outcomes were analyzed using Cox models.
Results. Compared with the No-Hx-Ca cohort, the Hx-Ca cohort had a higher proportion of older (61 yr. vs. 51 yr.;p<0.001), vasculopathic (20% vs. 15%;p<0.001), disabled (2.2% vs. 1.7%;p<0.001), and pre-emptively listed (31% vs 26%;p<0.001) patients.
Based on Kaplan Meier (KM) model (not shown), the 5-year transplantation-censored patient survival rates of waiting list Hx-Ca and No-Hx-Ca cohorts are: 77% and 78%, respectively (log rank p<0.001). On multi-variate analysis, pre-listing history of malignancy is not a risk factor for patient mortality [Hazard ratio (HR) 0.97, 95% confidence interval (CI): 0.92-1.01;p=0.16], (Cox Model Fig.1A).The 5-yr. probability of transplantation is lower for the Hx-Ca vs.No-Hx-Ca wait-listed patients (44% vs. 50%,log rank ;p<0.001), (KM model in Fig.1B). Multivariate analysis showed that Hx-Ca is a risk factor for non-transplantation compared with No-Hx-Ca (HR for KT 0.97, 95% CI 0.94-0.99;p=0.012), (Cox model not shown).
Conclusions. In the cohorts studied, a history of malignancy is associated with a decreased likelihood of receiving a kidney transplant, but not with increased risk of mortality within 5-years of wait-listing. With careful patient selection, a history of malignancy should not automatically preclude transplant listing. Generalizability of our findings and conclusions may be limited to centers reporting to SRTR.
To cite this abstract in AMA style:
Santos A, Casey M, Rehman S, Wen X, Andreoni K, Womer K. Outcome of Adult Kidney Transplant Candidates With Previous Malignancy: Analysis of 14-Year Waiting List Data in the United States [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/outcome-of-adult-kidney-transplant-candidates-with-previous-malignancy-analysis-of-14-year-waiting-list-data-in-the-united-states/. Accessed May 9, 2025.« Back to 2015 American Transplant Congress