Women are at significantly increased risk of urologic malignancies after kidney transplantation, but men are not, a study found.
Jyh-Chang Hwang, MD,of Chi Mei Medical Center in Tainan, Taiwan, studied 2,245 kidney transplant (KT) recipients who developed urologic malignancies and, using propensity scores, matched them by age and sex to a control group of 8,980 non-KT patients with end-stage renal disease (ESRD). Women KT recipients had a significant 2-fold increased risk of urologic malignancies compared with controls after adjusting for age and comorbidities, whereas men had a non-significant 47% increased risk, the investigators reported online ahead of print in Transplantation.
“The higher incidence rate of urologic malignancy in female recipients started to appear approximately 2 years after KT,” the authors noted.
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The investigators speculate that immunosuppressants prescribed after KT reactivated pre-existing dormant urologic malignancy initiated by the “uremia milieu” and use of Chinese herbal drugs and analgesics prior to ESRD.
In addition, the study found that after acquiring malignancy, KT recipients did not have any advantage in cumulative survival compared with the control group. “The diminished superiority for long-term survival of KT recipients compared to their non-KT counterparts after developing urologic malignancy may be caused by a more advanced stage of cancer at the time of diagnosis and the adverse impact of immunosuppression on cancer progression in the KT group,” the authors wrote.
