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Transplantation ; 101(6): 1303-1309, 2017 06.
Artículo en Inglés | MEDLINE | ID: mdl-27336396

RESUMEN

BACKGROUND: Posttransplant malignancy (PTM) is one of the leading causes of late death in kidney recipients. Those with a cancer history may be more prone to develop a recurrent or a new cancer. We studied the association between pretransplant skin cancer, PTM, death, and graft failure. METHODS: Primary adult kidney recipients transplanted between 2005 and 2013 were included. Malignancy information was obtained from Organ Procurement Kidney Transplant Network/United Network for Organ Sharing registration and follow-up forms. Posttransplant malignancy was classified into skin cancer, solid tumor, and posttransplant lymphoproliferative disorder (PTLD). Competing risk and survival analysis with adjustment for confounders were used to calculate risk for PTM, death and graft failure in recipients with pretransplant skin cancer compared with those without cancer. Risk was reported in hazard ratios (HR) with 95% confidence interval (CI). RESULTS: The cohort included 1671 recipients with and 102 961 without pretransplant skin malignancy. The 5-year cumulative incidence of PTM in patients with and without a pretransplant skin cancer history was 31.6% and 7.4%, respectively (P < 0.001). Recipients with pretransplant skin cancer had increased risk of PTM (sub-HR [SHR], 2.60; 95% CI, 2.27-2.98), and posttransplant skin cancer (SHR, 2.92; 95% CI, 2.52-3.39), PTLD (SHR, 1.93; 95% CI, 1.01-3.66), solid tumor (SHR, 1.44; 95% CI, 1.04-1.99), death (HR, 1.20; 95% CI, 1.07-1.34), and graft failure (HR, 1.17; 95% CI, 1.05-1.30) when compared with those without pretransplant malignancy. CONCLUSIONS: Pretransplant skin cancer was associated with an increased risk of posttransplant skin cancer, PTLD, solid organ cancer, death and graft failure.


Asunto(s)
Supervivencia de Injerto , Trasplante de Riñón/efectos adversos , Trastornos Linfoproliferativos/epidemiología , Recurrencia Local de Neoplasia , Complicaciones Posoperatorias/epidemiología , Neoplasias Cutáneas/epidemiología , Adolescente , Adulto , Femenino , Humanos , Incidencia , Estimación de Kaplan-Meier , Trasplante de Riñón/mortalidad , Trastornos Linfoproliferativos/diagnóstico , Trastornos Linfoproliferativos/mortalidad , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/mortalidad , Modelos de Riesgos Proporcionales , Sistema de Registros , Medición de Riesgo , Factores de Riesgo , Neoplasias Cutáneas/diagnóstico , Neoplasias Cutáneas/mortalidad , Factores de Tiempo , Obtención de Tejidos y Órganos , Resultado del Tratamiento , Estados Unidos/epidemiología , Adulto Joven
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