Abstract: TH-PO959

Malignancies after Pediatric Kidney Transplantation: A Long Term Single-Center Experience in Japan

Session Information

Category: Transplantation

  • 1702 Transplantation: Clinical and Translational

Authors

  • Yabuuchi, Tomoo, Tokyo Women's Medical University, Tokyo, Japan
  • Kaneko, Naoto, Tokyo Women's Medical University, Tokyo, Japan
  • Ishizuka, Kiyonobu, Tokyo Women's Medical University, Tokyo, Japan
  • Chikamoto, Hiroko, Tokyo Women's Medical University, Tokyo, Japan
  • Akioka, Yuko, Tokyo Women's Medical University, Tokyo, Japan
  • Hattori, Motoshi, Tokyo Women's Medical University, Tokyo, Japan
  • Miura, Ken-ichiro, Tokyo Women's Medical University, Tokyo, Japan
  • Kanda, Shoichiro, Tokyo Women's Medical University, Tokyo, Japan
  • Taniguchi, Yohei, Tokyo Women's Medical University, Tokyo, Japan
  • Nagasawa, Takeshi, Tokyo Women's Medical University, Tokyo, Japan
  • Hisatomi, Ryutaro, Tokyo Women's Medical University, Tokyo, Japan
  • Ban, Hideki, Tokyo Women's Medical University, Tokyo, Japan
  • Shirai, Yoko, Tokyo Women's Medical University, Tokyo, Japan
  • Takagi, Yoko, Tokyo Women's Medical University, Tokyo, Japan
Background

Kidney transplantation (KTx) is the preferred treatment option for children with end-stage renal disease. Today, approximately 11.3% of all deaths after pediatric KTx are related to cancer. With improved graft survival and overall survival, this proportion is likely to rise. Increased cancer risks are well documented in adult KTx recipients. However, the spectrum of malignancies and risk in the pediatric KTx population, particularly in Asia, are less well described.

Methods

We retrospectively reviewed medical charts of all consecutive pediatric KTx patients aged less than 20 years in our center between April 1983 and December 2016.

Results

During maximum 31 years of follow-up, 13 out of 363 patients (3.6%) developed malignancy, which included 3 EBV-associated posttransplant lymphoproliferative disorder (PTLD), 1 EBV-associated post-transplant smooth muscle tumor (PTSMT), 2 brain tumors, 1 B-cell lymphoma, 1 renal cell carcinoma, 1 thyroid carcinoma, 1 lung cancer, 1 bladder cancer, 1 breast cancer, and 1 Wilms tumor. Patients diagnosed with EBV-associated PTLD, EBV-associated PTSMT, and Wilms tumor were mostly transplanted at younger ages and the median age at diagnosis of malignancy was 6.6 years (range 5.5-11.5), with a median time to diagnosis of 1.2 years (range 0.6-1.2). In contrast, the median age at diagnosis of other malignancies was 27.6 years (range 20.4-31.8), and the median time from KTx to diagnosis of malignancy was 15.2 years (range 10.6-17.1). No EBV-associated PTLD has occurred since 2005, when we started regular screening of EBV-DNA load in children at risk for developing PTLD.

Conclusion

This is the first study which investigated occurrence of malignancies in pediatric KTx recipients in Asian populations. EBV-associated PTLD and PTSMT occurred during early periods from KTx. Regular screening of EBV-DNA load might be helpful to prevent EBV-associated PTLD. Other malignancies were diagnosed during early adulthood, emphasizing the need for long term surveillance of these patients.