Characteristics and Graft Survival of Kidney Transplant Recipients with Renal Cell Carcinoma.
BACKGROUND
The incidence of renal cell carcinoma (RCC) is higher in kidney transplant recipients (KTRs) compared to the general population. However, the risk factors and outcomes based on the diagnosis of RCC after kidney transplantation are limited.


METHODS
We analyzed risk factors for the development of RCC in KTRs transplanted at our institution between 1994 and 2016. We compared the incidence of graft failure and mortality in KTRs with RCC to matched controls using 5:1 event density sampling. Identifying the risk factors of RCC and patient and graft survival were outcomes of interest.


RESULTS
There were 4,178 KTRs performed at our institution during the study period, and 51 patients were diagnosed with RCC. Recipients were followed until graft failure or death. We did not identify commonly looked at baseline characteristics associated with the risk of RCC. Comparing KTRs with RCC to matched controls, RCC patients were younger (47.5 vs. 49.6 years, p < 0.01), received basiliximab induction more commonly (p = 0.01), had hypertension and glomerulonephritis as causes of end-stage renal disease (p = 0.01), and were more likely to be smokers (p < 0.01). RCC was significantly associated with death-censored graft failure (adjusted hazard ratio [HR]: 1.76; 95% CI: 1.02-3.03; p = 0.04) but not patient death (adjusted HR: 0.95; 95% CI: 0.50-1.83; p = 0.89).


CONCLUSION
In our experience, RCC had a detrimental impact on graft survival among KTRs, highlighting the potential benefit of early diagnosis and optimal immunosuppression management in optimizing graft survival.
['Machhi|Rushad|R|', 'Mandelbrot|Didier A|DA|', 'Al-Qaoud|Talal|T|', 'Astor|Brad C|BC|', 'Parajuli|Sandesh|S|']
D002292:Carcinoma, Renal Cell D016022:Case-Control Studies D005260:Female D005500:Follow-Up Studies D006084:Graft Rejection D006085:Graft Survival D006801:Humans D007166:Immunosuppressive Agents D015994:Incidence D007676:Kidney Failure, Chronic D007680:Kidney Neoplasms D016030:Kidney Transplantation D008297:Male D008875:Middle Aged D012189:Retrospective Studies D018570:Risk Assessment D012307:Risk Factors
Graft survival Kidney transplant Renal cell carcinoma Immunosuppressed