PMID- 34580806 OWN - NLM STAT- MEDLINE DCOM- 20220404 LR - 20220405 IS - 1437-7799 (Electronic) IS - 1342-1751 (Print) IS - 1342-1751 (Linking) VI - 26 IP - 3 DP - 2022 Mar TI - Incidence of malignancy after pediatric kidney transplantation: a single-center experience over the past three decades in Japan. PG - 294-302 LID - 10.1007/s10157-021-02143-3 [doi] AB - BACKGROUND: Malignancy after kidney transplantation (KT) is one of the most serious post-transplant complications. This study aimed to investigate the incidence, type, and outcomes of malignancy after pediatric KT. METHODS: We performed a retrospective cohort study on pediatric kidney transplant recipients aged 18 years or younger who received their first transplant between 1975 and 2009. RESULTS: Among the 375 children who underwent KT, 212 were male (56.5%) and 163 were female (43.5%) (median age at KT, 9.6 years [interquartile range IQR] 5.8-12.9 years). The incidence of malignancy was 5.6% (n = 21). The cumulative incidences of cancer were 0.8%, 2.5%, 2.8%, 4.2%, 5.5%, and 15.6% at 1, 5, 10, 15, 20, and 30 years post-transplantation, respectively. Of 375 patients, 12 (3.2%) had solid cancer and nine (2.4%) had lymphoproliferative malignancy. The median age at the first malignancy was 21.3 years (IQR 11.5-33.3 years). The median times from transplant to diagnosis were 22.3 years (IQR 12.3-26.6 years) for solid cancer and 2.2 years (IQR 0.6-2.8) for lymphoproliferative malignancies. During follow-up, five recipients died due to malignancy. The causes of death were hepatocellular carcinoma in one patient, squamous cell carcinoma in the transplanted kidney in one patient, malignant schwannoma in one patient, and Epstein-Barr virus-related lymphoma in two patients. The mortality rate was 0.79 per 1000 person-years (95% confidence interval 0.38, 1.85). CONCLUSIONS: Early diagnosis and treatment of malignancies in transplant recipients is an important challenge. Therefore, enhanced surveillance and continued vigilance for malignancy following KT are necessary. CI - (c) 2021. The Author(s). FAU - Aoki, Yujiro AU - Aoki Y AD - Department of Urology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan. y.aoki@med.toho-u.ac.jp. AD - Department of Nephrology, Toho University Faculty of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo, 143-8541, Japan. y.aoki@med.toho-u.ac.jp. FAU - Satoh, Hiroyuki AU - Satoh H AD - Department of Urology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan. FAU - Hamasaki, Yuko AU - Hamasaki Y AD - Department of Nephrology, Toho University Faculty of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo, 143-8541, Japan. AD - Department of Nephrology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan. FAU - Hamada, Riku AU - Hamada R AD - Department of Nephrology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan. FAU - Harada, Ryoko AU - Harada R AD - Department of Nephrology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan. FAU - Hataya, Hiroshi AU - Hataya H AD - Department of Nephrology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan. AD - Department of General Pediatrics, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan. FAU - Ishikura, Kenji AU - Ishikura K AD - Department of Nephrology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan. AD - Department of Pediatrics, Kitasato University School of Medicine, Kanagawa, Japan. FAU - Muramatsu, Masaki AU - Muramatsu M AD - Department of Nephrology, Toho University Faculty of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo, 143-8541, Japan. FAU - Shishido, Seiichiro AU - Shishido S AD - Department of Nephrology, Toho University Faculty of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo, 143-8541, Japan. FAU - Sakai, Ken AU - Sakai K AD - Department of Nephrology, Toho University Faculty of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo, 143-8541, Japan. LA - eng PT - Journal Article DEP - 20210927 PL - Japan TA - Clin Exp Nephrol JT - Clinical and experimental nephrology JID - 9709923 SB - IM MH - Adolescent MH - Child MH - Child, Preschool MH - Early Detection of Cancer/adverse effects MH - *Epstein-Barr Virus Infections/complications MH - Female MH - Herpesvirus 4, Human MH - Humans MH - Incidence MH - Japan/epidemiology MH - *Kidney Transplantation/adverse effects MH - Male MH - *Neoplasms/epidemiology/etiology MH - Retrospective Studies MH - Risk Factors PMC - PMC8847171 OTO - NOTNLM OT - Kidney transplantation OT - Malignancy OT - Pediatric OT - Post-transplantation lymphoproliferative disease COIS- Yuko Hamasaki belongs to an endowed department sponsored by Asahi Kasei Pharma Corporation, Novartis Pharma K.K., Chugai Pharmaceutical Co., and Astellas Pharma (until 28/Feb/2018). Seiichiro Shishido belongs to an endowed department sponsored by Asahi Kasei Pharma Corporation, Novartis Pharma K.K., and Chugai Pharmaceutical Co. The other authors have no potential conflicts of interest to disclose. EDAT- 2021/09/29 06:00 MHDA- 2022/04/05 06:00 PMCR- 2021/09/27 CRDT- 2021/09/28 06:49 PHST- 2021/05/26 00:00 [received] PHST- 2021/09/23 00:00 [accepted] PHST- 2021/09/29 06:00 [pubmed] PHST- 2022/04/05 06:00 [medline] PHST- 2021/09/28 06:49 [entrez] PHST- 2021/09/27 00:00 [pmc-release] AID - 10.1007/s10157-021-02143-3 [pii] AID - 2143 [pii] AID - 10.1007/s10157-021-02143-3 [doi] PST - ppublish SO - Clin Exp Nephrol. 2022 Mar;26(3):294-302. doi: 10.1007/s10157-021-02143-3. Epub 2021 Sep 27.