A
study led by researchers at RCSI (Royal College of Surgeons in Ireland) has
analysed the pattern of skin cancer rates in kidney transplant patients, which
suggests the increased risk is related to the anti-rejection medications.
Patients
who receive a kidney transplant are at increased risk of cancer, in particular
skin cancer. The study found that this
skin cancer risk falls when the transplant fails and the patients return to
dialysis but rises again when they receive another transplant. However, the
rate of skin cancer is still higher in patients with failed transplants than
pre-transplant patients on dialysis.
Due
to this pattern of skin cancer rates, the data suggests that the cancer risk is
related to the stopping and starting of anti-rejection medications.
“In
recipients of multiple kidney transplants, the incidence of nonmelanoma skin
cancer fell during periods defined by transplant failure, but there was still
an elevated risk. The incidence of cancer overall
highlights the need for continued cancer surveillance during graft failure,”
said the study’s lead author Dr Donal Sexton, Department of Nephrology and
Kidney Transplantation, Beaumont Hospital, RCSI.
The
study analysed the rates of cancer in 3,821 individual deceased and living
kidney transplant recipients. Of the patients analysed, 3,215 recipients had one transplant, 522 recipients a second;
and 84 recipients had three kidney transplants.
During
the patient’s first kidney transplant, the rate of skin cancer rose 15 times
higher than before the procedure. That skin cancer rate fell by half when the
transplant failed and the patient returned to dialysis; however, the rate was
still seven times higher than the pre-transplant patient’s rate. When they
received a second transplant, the rate of skin cancer rose again to 12.8 times
more than pre-transplant rate.
“Our
study has provided a comprehensive analysis of cancer risk over multiple kidney
transplants in the same individuals. However, the retrospective nature of the
analysis makes it difficult to capture the effect of the lag between exposure,
cancer development, presentation, and diagnosis, and which may vary by
treatment period,“ said Professor Peter Conlon,
Associate Professor of Medicine at RCSI.
RCSI
is ranked among the top 250 (top 2%) of universities worldwide in the Times
Higher Education World University Rankings (2019) and its research is ranked
first in Ireland for citations. It is an international not-for-profit health
sciences institution, with its headquarters in Dublin, focused on education and
research to drive improvements in human health worldwide. RCSI has been awarded
Athena Swan Bronze accreditation for positive gender practice in higher
education.
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