Assessment of kidney transplant suitability for patients with prior cancers: is it time for a rethink?

Transplant International : Official Journal of the European Society for Organ Transplantation
Wai H LimGermaine Wong

Abstract

Kidney transplant recipients have up to a 100-fold greater risk of incident cancer compared with the age/sex-matched general population, attributed largely to chronic immunosuppression. In patients with a prior history of treated cancers, the type, stage and the potential for cancer recurrence post-transplant of prior cancers are important factors when determining transplant suitability. Consequently, one of the predicaments facing transplant clinicians is to determine whether patients with prior cancers are eligible for transplantation, balancing between the accelerated risk of death on dialysis, the projected survival benefit and quality of life gains with transplantation, and the premature mortality associated with the potential risk of cancer recurrence post-transplant. The guidelines informing transplant eligibility or screening and preventive strategies against cancer recurrence for patients with prior cancers are inconsistent, underpinned by uncertain evidence on the estimates of the incidence of cancer recurrence and the lack of stage-specific outcomes data, particularly among those with multiple myeloma or immune-driven malignancies such as melanomas. With the advent of newer anti-cancer treatment options, it is unclea...Continue Reading

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Citations

Mar 20, 2020·Clinical Medicine : Journal of the Royal College of Physicians of London·Revathy Manickavasagar, Raj Thuraisingham
Mar 19, 2020·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Evan J LipsonDaniel C Brennan
Feb 15, 2021·Seminars in Cancer Biology·Alexandre CorthayColin C Anderson

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BETA
imaging technique
biopsy

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