Safety of a Short (One-Year) Waiting Time in Kidney Transplant Candidates Treated for Cancer.
1Department of Transplant Medicine, Oslo University Hospital, Oslo, Norway
2The Cancer Registry of Norway, Oslo, Norway
3Norwegian Renal Registry, Oslo University Hospital, Oslo, Norway.
Meeting: 2016 American Transplant Congress
Abstract number: 159
Keywords: Kidney transplantation, Malignancy
Session Information
Date: Sunday, June 12, 2016
Session Name: Concurrent Session: Older and High Risk Kidney Transplant Recipients/Donors
Session Time: 4:30pm-6:00pm
Presentation Time: 5:42pm-5:54pm
Location: Ballroom A
In Norway, a one-year waiting time free of cancer recurrence is required before kidney transplantation. To provide an updated, large-scale assessment of this practice, the survival of such a group of patients was compared to that of a matched cohort of kidney transplant recipients (KTRs) without a history of pretransplant cancer.
Methods: KTRs with pretransplant cancer were identified in the Cancer Registry. Combined organ transplantations were excluded. Basal cell carcinoma was not uniformly registered and excluded as cancer diagnosis. No waiting time was required for localized prostate cancer, but this diagnosis was also included. A control group of KTRs without pretransplant cancer was constructed by coarsened exact matching in Stata, with age, gender and transplant era (<1983, 1983-1999, >2000) as matching variables. Follow-up was censored by November 2013, and survival compared by Kaplan-Meier plot and Cox regression.
Results: From 1963 to 2010, 5622 KTRs were included, of whom 361 had a history of pretransplant cancer. The median follow-up (interquartile range) was 6.2 (0.3-11.5) years. 2980 patients died, 30/361 (8.3%) of a cancer recurrence, of whom 6/103 of renal cancer, 5/43 prostate, 4/35 colorectal, 5/40 urothelial, 1/26 breast, 3/20 melanoma, 1/6 lung, 0/11 Non-Hodgkin lymphoma, 1/3 Hodgkin lymphoma, 3/15 plasma cell neoplasia, 0/10 cervix, and 1/1 acute myeloid leukemia. Patient survival in KTRs with a history of pretransplant cancer was similar to that of controls (Figure), hazard ratio (HR) 1.06 (95% CI 0.93-1.22), p=0.39. Defining waiting time from diagnosis of cancer to transplantation, there was no increased risk after stratifying for waiting times: 0-1 year (n=34; HR 1.03 [0.69-1.54], p=0.90), 1-2 years (n=49; HR 0.93 [0.63-1.39], p=0.74), 2-5 years (n=116; HR 1.14 [0.90-1.44], p=0.26) or >5 years (n=162; HR=1.07 [0.87-1.32], p=0.52).
Conclusion: A short (one year) waiting time after cancer was not associated with increased mortality in KTRs.
CITATION INFORMATION: Dahle D, Grotmol T, Leivestad T, Hartmann A, Mjøen G, Pihlstrøm H, Næss H, Holdaas H. Safety of a Short (One-Year) Waiting Time in Kidney Transplant Candidates Treated for Cancer. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Dahle D, Grotmol T, Leivestad T, Hartmann A, Mjøen G, Pihlstrøm H, Næss H, Holdaas H. Safety of a Short (One-Year) Waiting Time in Kidney Transplant Candidates Treated for Cancer. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/safety-of-a-short-one-year-waiting-time-in-kidney-transplant-candidates-treated-for-cancer/. Accessed March 4, 2021.« Back to 2016 American Transplant Congress