Cancer risk and mortality after kidney transplantation: A population-based study on differences between Danish centres using standard immunosuppression with and without glucocorticoids

Henriette Engberg, Sonja Wehberg, Claus Bistrup, James Heaf, Søren Schwartz Sørensen, Helle Charlotte Thiesson, Jesper Melchior Hansen, My Svensson, Anders Green, Peter Marckmann

Publikation: Bidrag til tidsskriftArtikelForskningpeer review

Abstrakt

Background. Kidney recipients receive immunosuppression to prevent graft rejection, and long-term outcomes such as post-transplant cancer and mortality may vary according to the different protocols of immunosuppression. Methods. A national register-based historical cohort study was conducted to examine whether post-transplant cancer and all-cause mortality differed between Danish renal transplantation centres using standard immunosuppressive protocols including steroids (Centres 2, 3, 4) or a steroid-free protocol (Centre 1). The Danish Nephrology Registry, the Danish Civil Registration System, the Danish National Cancer Registry and the Danish National Patient Register were used. A historical cohort of 1450 kidney recipients transplanted in 1995-2005 was followed up with respect to post-transplant cancer and death until 31 December 2011. Results. Compared with Center 1 the adjusted post-transplant cancer risk was 6-39% lower in Centre 3 [hazard ratio (HR) 0.94, 95% confidence interval (CI) 0.67-1.32], in Centre 2 (HR 0.72, 95% CI 0.52-0.98) and in Centre 4 (HR 0.61, 95% CI 0.44-0.83). Compared with Center 1, the adjusted post-transplant mortality was 21-55% higher in Centre 4 (HR 1.21, 95% CI 0.91-1.61), in Centre 3 (HR 1.35, 95% CI 0.98-1.86) and in Centre 2 (HR 1.55, 95% CI 1.17-2.05). On average, post-transplant cancer was associated with a 4-fold increase in the risk of death (HR 4.25, 95% CI 3.36-5.38). Conclusions. There was a tendency of a higher post-transplant cancer occurrence, but lower all-cause mortality, in the Danish transplantation centre that adhered to a standard steroid-free immunosuppressive protocol.

OriginalsprogEngelsk
Sider (fra-til)2149-2156
Antal sider8
TidsskriftNephrology Dialysis Transplantation
Vol/bind31
Udgave nummer12
DOI
StatusUdgivet - 1 jan. 2016

Fingeraftryk Udforsk hvilke forskningsemner 'Cancer risk and mortality after kidney transplantation: A population-based study on differences between Danish centres using standard immunosuppression with and without glucocorticoids' indeholder.

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