Cancer morbidity and mortality after pediatric solid organ transplantation-a nationwide register study.
Adolescent
Adult
Case-Control Studies
Female
Finland
/ epidemiology
Heart Transplantation
/ adverse effects
Humans
Immunosuppression Therapy
/ adverse effects
Kidney Transplantation
/ adverse effects
Liver Transplantation
/ adverse effects
Male
Neoplasms
/ epidemiology
Prevalence
Registries
Risk Assessment
Transplant Recipients
/ statistics & numerical data
Young Adult
Adolescent
Adult
Cancer
Follow-up
Mortality
Pediatric transplantation
Journal
Pediatric nephrology (Berlin, Germany)
ISSN: 1432-198X
Titre abrégé: Pediatr Nephrol
Pays: Germany
ID NLM: 8708728
Informations de publication
Date de publication:
09 2020
09 2020
Historique:
received:
07
11
2019
accepted:
19
03
2020
revised:
18
03
2020
pubmed:
13
5
2020
medline:
16
6
2021
entrez:
13
5
2020
Statut:
ppublish
Résumé
The prevalence of malignancies after pediatric solid organ transplantation was evaluated in a nationwide study. All patients who had undergone kidney, liver, or heart transplantation during childhood between the years 1982 and 2015 in Finland were identified. The inclusion criteria were age under 16 years at transplantation and age over 18 years at the last follow-up day. A total of 233 (137 kidney, 53 liver, and 43 heart) transplant recipients were enrolled. Controls (n = 1157) matched by the year of birth, gender, and hometown were identified using the Population Register Center registry. The cancer diagnoses were searched using the Finnish Cancer Registry. Altogether 26 individuals diagnosed with cancer were found, including 18 transplant recipients. Cancer was diagnosed at a median of 12.0 (IQR 7.8-17.8) years after the transplantation. The transplant recipients' risk for cancer was significantly higher when compared with the controls (HR 14.7; 95% CI 6.4-33.9). There was no difference for different graft types. Sixty-one percent of cancers among the transplant recipients were diagnosed at age older than 18 years. The risk for cancer is significantly higher among young adults having undergone solid organ transplantation during childhood in comparison with population controls. Careful follow-up and attention to prevent cancers throughout adulthood are warranted.
Sections du résumé
BACKGROUND
The prevalence of malignancies after pediatric solid organ transplantation was evaluated in a nationwide study.
METHODS
All patients who had undergone kidney, liver, or heart transplantation during childhood between the years 1982 and 2015 in Finland were identified. The inclusion criteria were age under 16 years at transplantation and age over 18 years at the last follow-up day. A total of 233 (137 kidney, 53 liver, and 43 heart) transplant recipients were enrolled. Controls (n = 1157) matched by the year of birth, gender, and hometown were identified using the Population Register Center registry. The cancer diagnoses were searched using the Finnish Cancer Registry.
RESULTS
Altogether 26 individuals diagnosed with cancer were found, including 18 transplant recipients. Cancer was diagnosed at a median of 12.0 (IQR 7.8-17.8) years after the transplantation. The transplant recipients' risk for cancer was significantly higher when compared with the controls (HR 14.7; 95% CI 6.4-33.9). There was no difference for different graft types. Sixty-one percent of cancers among the transplant recipients were diagnosed at age older than 18 years.
CONCLUSION
The risk for cancer is significantly higher among young adults having undergone solid organ transplantation during childhood in comparison with population controls. Careful follow-up and attention to prevent cancers throughout adulthood are warranted.
Identifiants
pubmed: 32394187
doi: 10.1007/s00467-020-04546-y
pii: 10.1007/s00467-020-04546-y
pmc: PMC7385020
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
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