Risk factors and incidence of malignant neoplasms after kidney transplantation at a single institution in Japan
Risk factors and incidence of malignant neoplasms after kidney transplantation at a single institution in Japan
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DOI：
10.1007/s10157-019-01769-8
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发表时间：
2019-11-01
影响因子：
2.3
通讯作者：
Koie, Takuya
中科院分区：
文献类型：
--
作者：
Horie, Kengo;Tsuchiya, Tomohiro;Koie, Takuya
背景肾移植受者发生恶性肿瘤的风险增加。然而，自2000年以来，尚未报告日本登记研究。方法回顾性分析2000年以来在日本岐阜大学医院接受KT的346例患者的病历。根据KT后是否发生恶性肿瘤，将患者分为两组。研究恶性肿瘤的发生率、类型、危险因素和预后。结果在本研究中，20例KTR（7.3%）中发现了22例原发性恶性肿瘤，中位随访时间为8.2年。1年内任何恶性肿瘤的累积发生率为1.1%，5年内为4.4%。5年总生存率（OS）在有恶性肿瘤的KTR中为71.8%，在无恶性肿瘤的KTR中为98.6%。单因素和多因素分析显示，KT时的年龄和急性排斥反应（AR）事件是恶性肿瘤发生率的重要预测因素。结论恶性肿瘤的发生与移植肾的生存率和总生存率有关。我们认为，适当的筛查和调查的症状是很重要的KTR，特别是老年KTR移植和AR事件。
Background The risk of malignant neoplasms increases in kidney transplantation (KT) recipients (KTRs). However, Japanese registry studies have not been reported since 2000. Methods We retrospectively reviewed the medical records of 346 patients who underwent KT at Gifu University Hospital, Japan since 2000. Patients were divided into two groups based on whether they developed malignancy after KT or not. The incidence, type of malignancy, risk factors, and prognosis for malignancy were examined. Results In this study, 22 de novo malignant neoplasms were identified in 20 KTRs (7.3%), with a median follow-up period of 8.2 years. Cumulative incidence of any malignant neoplasms was 1.1% within 1 year and 4.4% within 5 years. The 5-year overall survival (OS) rates were 71.8% in KTRs with malignant neoplasms and 98.6% in KTRs without malignant neoplasms. Uni- and multivariate analysis revealed that age at KT and acute rejection (AR) episode were significant predictors for incidence of malignancy. Conclusions The development of malignant neoplasms was associated with poor OS and graft survival. We consider that appropriate screening and investigation of symptoms are important for KTRs, particularly for older KTRs at transplantation and those with AR episode.