Abstract: FR-PO1144
Graft Survival and Characteristics of Kidney Transplant Recipients with Renal Cell Carcinoma
Session Information
- Transplantation: Clinical - Post-Transplant Complications
November 08, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 1902 Transplantation: Clinical
Authors
- Machhi, Rushad, University of Wisconsin School of Medicine and Public Health, Mequon, Wisconsin, United States
- Astor, Brad C., University of Wisconsin, Madison, Wisconsin, United States
- Mandelbrot, Didier A., U of Wisconsin Hospital, Madison, Wisconsin, United States
- Parajuli, Sandesh, UW Health, Madison, Wisconsin, United States
Background
The risk of acquiring renal cell carcinoma (RCC) is the greatest among all solid tumors in kidney transplant recipients (KTRs). While most RCCs are caught in the localized stage incidentally, leading to low cancer-specific mortality, there is limited information on how to properly screen for RCC in KTRs based on risk stratification, and how RCC impacts graft survival down the line.
Methods
We analyzed risk factors and determined patient and graft survival of all KTRs with RCC in both native and grafted kidneys compared to those without RCC in our institution between 01/01/1994 and 12/31/2014. Risk factors analyzed were race, age, mean time on dialysis prior to transplantation, causes of ESRD, re-transplant, type of graft, and type of induction agent.
Results
48 cases of RCC were found among the 4,837 KTR’s performed at our institution. The mean interval from transplant to RCC was 8.0±6.3 years. Glomerulonephritis was the most common cause of ESRD in KTRs with RCC at our institution (n=17), but this was not found to be a signficfant risk factor for acquiring RCC (p=0.54 in univariate analysis, p=0.42 in multivariate analysis). None of the risk factors analyzed were associated with a statistically significant higher risk for RCC . Graft survival at 10 years was significantly lower in KTRs with RCC compared to those without (Figure 1, p<0.001). However, the trend toward shorter 10 year patient survival did not reach statistical significance (p=0.13).
Conclusion
Although no factor was identified in our sample population that specifically was associated with increased risk for RCC in KTRs, KTRs with RCC were found to have significantly lower graft survival. Identifying specific risk factors in patients with graft failure following RCC can lead to better screening, treatment, and immunosuppression strategies to bolster graft survival in KTRs with RCC.