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Tumor Recurrence and Graft Survival in Renal Transplant Recipients with a History of Pretransplant Malignancy: A Matched Pair Analysis

Organ scarcity demands critical decision-making regarding eligible transplant candidates and graft allocation to ensure best benefit from renal transplantation (RTx). Among the controversial relative contraindications is a history of pretransplant malignancy (PTM). While oncological outcomes of PTM-...

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Autores principales: Becker, Felix, Mehdorn, Anne-Sophie, Getsopulos, Vasilios, Schütte-Nütgen, Katharina, Reuter, Stefan, Suwelack, Barbara, Pascher, Andreas, Brockmann, Jens G., Bahde, Ralf
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8199231/
https://www.ncbi.nlm.nih.gov/pubmed/34071904
http://dx.doi.org/10.3390/jcm10112349
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author Becker, Felix
Mehdorn, Anne-Sophie
Getsopulos, Vasilios
Schütte-Nütgen, Katharina
Reuter, Stefan
Suwelack, Barbara
Pascher, Andreas
Brockmann, Jens G.
Bahde, Ralf
author_facet Becker, Felix
Mehdorn, Anne-Sophie
Getsopulos, Vasilios
Schütte-Nütgen, Katharina
Reuter, Stefan
Suwelack, Barbara
Pascher, Andreas
Brockmann, Jens G.
Bahde, Ralf
author_sort Becker, Felix
collection PubMed
description Organ scarcity demands critical decision-making regarding eligible transplant candidates and graft allocation to ensure best benefit from renal transplantation (RTx). Among the controversial relative contraindications is a history of pretransplant malignancy (PTM). While oncological outcomes of PTM-RTx recipients are well described, data on graft-specific outcome are scarce. A retrospective double case control matched pair analysis (60 months follow-up) was carried out and RTx-recipients were stratified for history of PTM. First, PTM-RTx recipients were matched according to age, sex and duration of immunosuppressive therapy. Next, PTM-RTx recipients were matched 1:1 for age, sex and cause of end-stage renal disease. Five-year patient and graft survival as well as oncological outcomes were analyzed. A total of 65 PTM-RTx recipients were identified. Post-RTx recurrence rate was 5%, while 20% developed second de novo malignancy, comparable to 14% in the control group. PTM-RTx recipients had a noticeable lower five-year death-censored as well as overall graft survival and Cox proportional hazard modeling showed a correlation between PTM and inferior graft survival. Although underlying reasons remain not fully understood, this study is the first to show inferior graft survival in PTM-RTx recipients and advocates necessity to focus on more meticulous graft monitoring in PTM recipients in addition to heightened surveillance for cancer recurrence.
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spelling pubmed-81992312021-06-14 Tumor Recurrence and Graft Survival in Renal Transplant Recipients with a History of Pretransplant Malignancy: A Matched Pair Analysis Becker, Felix Mehdorn, Anne-Sophie Getsopulos, Vasilios Schütte-Nütgen, Katharina Reuter, Stefan Suwelack, Barbara Pascher, Andreas Brockmann, Jens G. Bahde, Ralf J Clin Med Article Organ scarcity demands critical decision-making regarding eligible transplant candidates and graft allocation to ensure best benefit from renal transplantation (RTx). Among the controversial relative contraindications is a history of pretransplant malignancy (PTM). While oncological outcomes of PTM-RTx recipients are well described, data on graft-specific outcome are scarce. A retrospective double case control matched pair analysis (60 months follow-up) was carried out and RTx-recipients were stratified for history of PTM. First, PTM-RTx recipients were matched according to age, sex and duration of immunosuppressive therapy. Next, PTM-RTx recipients were matched 1:1 for age, sex and cause of end-stage renal disease. Five-year patient and graft survival as well as oncological outcomes were analyzed. A total of 65 PTM-RTx recipients were identified. Post-RTx recurrence rate was 5%, while 20% developed second de novo malignancy, comparable to 14% in the control group. PTM-RTx recipients had a noticeable lower five-year death-censored as well as overall graft survival and Cox proportional hazard modeling showed a correlation between PTM and inferior graft survival. Although underlying reasons remain not fully understood, this study is the first to show inferior graft survival in PTM-RTx recipients and advocates necessity to focus on more meticulous graft monitoring in PTM recipients in addition to heightened surveillance for cancer recurrence. MDPI 2021-05-27 /pmc/articles/PMC8199231/ /pubmed/34071904 http://dx.doi.org/10.3390/jcm10112349 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Becker, Felix
Mehdorn, Anne-Sophie
Getsopulos, Vasilios
Schütte-Nütgen, Katharina
Reuter, Stefan
Suwelack, Barbara
Pascher, Andreas
Brockmann, Jens G.
Bahde, Ralf
Tumor Recurrence and Graft Survival in Renal Transplant Recipients with a History of Pretransplant Malignancy: A Matched Pair Analysis
title Tumor Recurrence and Graft Survival in Renal Transplant Recipients with a History of Pretransplant Malignancy: A Matched Pair Analysis
title_full Tumor Recurrence and Graft Survival in Renal Transplant Recipients with a History of Pretransplant Malignancy: A Matched Pair Analysis
title_fullStr Tumor Recurrence and Graft Survival in Renal Transplant Recipients with a History of Pretransplant Malignancy: A Matched Pair Analysis
title_full_unstemmed Tumor Recurrence and Graft Survival in Renal Transplant Recipients with a History of Pretransplant Malignancy: A Matched Pair Analysis
title_short Tumor Recurrence and Graft Survival in Renal Transplant Recipients with a History of Pretransplant Malignancy: A Matched Pair Analysis
title_sort tumor recurrence and graft survival in renal transplant recipients with a history of pretransplant malignancy: a matched pair analysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8199231/
https://www.ncbi.nlm.nih.gov/pubmed/34071904
http://dx.doi.org/10.3390/jcm10112349
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