title: Solid tumors following kidney transplantation in children.
abstract: Kidney transplant recipients have an increased risk of cancer. Data on non-LPD malignancies (solid tumors) in pediatric renal transplant recipients are limited. We performed a cohort study using the NAPRTCS transplant registry to describe the incidence of non-LPD malignancy compared with the general pediatric population. The observed incidence rate of non-LPD malignancy in the NAPRTCS transplant registry was 72.1 per 100,000 person-years (SIR 6.7; 95% CI, 5.3, 8.5); a 6.7-fold increased risk compared with the general pediatric population (10.7 cases per 100,000 person-years). Non-LPD malignancy was diagnosed in 35 subjects at a median of 726 days post-transplant. The most common type of malignancy was renal cell carcinoma. The increased risk of non-LPD malignancy was seen in all patients regardless of age, gender, race, etiology of end-stage kidney disease, and transplant era. The specific type of immunosuppression was not identified as a risk factor. In this first large-scale study of North American pediatric renal transplant recipients, we observed a 6.7-fold increased risk of non-LPD malignancy compared with the general pediatric population. Further examination of this unique patient population may provide greater insight into the impact of transplant and immunosuppression on malignancy risk.
authors.affiliation: Seattle Children's Hospital, University of Washington, Seattle, WA, USA.
authors.forename: Jodi M
authors.initials: JM
authors.lastname: Smith
authors.forename: Karen
authors.initials: K
authors.lastname: Martz
authors.forename: Ruth A
authors.initials: RA
authors.lastname: McDonald
authors.forename: William E
authors.initials: WE
authors.lastname: Harmon
mesh_terms: D002292:Carcinoma, Renal Cell / Q000209:etiology*; D002648:Child; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000453:epidemiology / Q000628:therapy; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D009369:Neoplasms / Q000453:epidemiology / Q000209:etiology*; D009656:North America; D010372:Pediatrics; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D018426:SEER Program
keywords: kidney transplant; malignancy; pediatric