Introduction Cancer is a significant cause of morbidity and mortality after kidney transplantation but risk differs e.g. non-melanoma skin cancers have a better prognosis compared to other cancers. The aim of this project was to stratify cancer risk based upon patient characteristics and differentiate risk for development of skin versus non-skin cancer.

Methods Data was extracted from hospital informatics systems for all kidney allograft recipients transplanted at our centre between 2007 and 2015. Electronic patient records were manually searched to facilitate data linkage to create a comprehensive database of baseline demographics, donor details, biochemical parameters, histology and clinical events.

Results Data was extracted for 1,140 kidney allograft recipients, with median follow up 4.4 years post-transplantation. Median age was 47, males (n=681, 59.7%), Caucasian ethnicity (n=822, 72.1%), deceased-donor recipients (n=633, 56.4%), repeat transplants (n=111, 9.7%), diabetes as cause of end-stage kidney disease (n=117, 10.3%) and smoking exposure (n=274, 24.0%). 69 patients developed post-transplant cancer of which 31.9% were skin cancers (including melanoma). Patients developing skin or non-skin cancer were older (53.6 years and 51.8 years) versus recipients who did not develop cancer (45.8 years, p<0.001). Male recipients were more likely to develop both skin and non-skin cancer post-transplantation compared to females (p=0.007), with 81.8% of skin cancer seen in male recipients. Patients with any smoking exposure had increased risk for both skin and non-skin cancers (3.3% and 6.9%) compared to recipients who had never smoked (1.6% versus 3.3%, p=0.005). 91% of skin cancer cases occurred among Caucasian kidney allograft recipients. Recipients who developed post-transplant diabetes mellitus appeared to have a slightly increased risk of developing skin cancers (versus both pre-existing diabetics and non-diabetics), but not for non-skin cancers (5.4% versus 2.6% versus 1.5%, p=0.042).

Discussion We have shown significant differences in cancer risk and in particular, skin cancer risk, according to different patient factors. Our data supports the rationale that clinicians should provide tailored counselling and risk stratification of cancer post-transplantation.

CITATION INFORMATION: Jackson-Spence F, Gillott H, Tahir S, Evison F, Nath J, Sharif A. Stratifying Skin Versus Non-Skin Cancer Risk Post-Kidney Transplantation According to Patient Characteristics. Am J Transplant. 2016;16 (suppl 3).

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