The risk of cancer is not increased in patients with multiple kidney transplantations.
BACKGROUND
The aim of this study was to investigate whether the number of transplantations, as a marker of the graft rejection status of the patient, is associated with an increased risk of malignancies.


METHODS
In a cohort study, 1213 patients, receiving a kidney transplantation between 1966 and 1995 at the Leiden University Medical Center, were analyzed. All cutaneous squamous cell carcinoma and internal malignancies, which had developed between 1966 and 2007, were recorded. The influence of number of transplantations, age, sex and time on immunosuppression on the risk of squamous cell carcinoma and internal malignancies was investigated by time-dependent multivariate Cox's proportional hazard models.


RESULTS
Of the 1213 kidney transplant recipients, 319 received a second kidney, 78 a third; 13 of them a fourth and 4 of them a fifth transplantation. After adjustment for potentially confounding factors, including age, sex and years on immunosuppressive therapy we did not detect an increased risk of cancer in patients with multiple transplantations. On the contrary, patients with three or more transplantations had a 1.6-fold decreased risk of squamous cell carcinomas and a 3.6-fold decreased risk of internal malignancies.


CONCLUSIONS
We conclude that kidney transplant recipients with three or more transplantations do not have an increased risk of cutaneous squamous cell carcinoma and internal malignancies.
Department of Dermatology, Leiden University Medical Center, Leiden, The Netherlands. h.c.wisgerhof@lumc.nl
Hermina C
HC
Wisgerhof
Ron
R
Wolterbeek
Geert W
GW
Haasnoot
Frans H J
FH
Claas
Johan W
JW
de Fijter
Rein
R
Willemze
Jan N
JN
Bouwes Bavinck
D000293:Adolescent; D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000209:etiology; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000276:immunology; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000209:etiology*; D012086:Reoperation / Q000009:adverse effects; D012307:Risk Factors; D012878:Skin Neoplasms / Q000209:etiology; D055815:Young Adult