Study: Kidney transplant recipients face higher risk of melanoma
Tuesday, August 22, 2017
Kidney transplant recipients face a greater risk of melanoma, according to a recent study published in JAMA Dermatology.
Researchers in the study also identified several risk factors for the development of melanoma among those who have received kidney transplants. Recipients who are older, white, use sirolimus or cyclosporine, or received a kidney from a living donor are at higher risk for this type of skin cancer.
"We believe that the risk factors we identified can guide clinicians in providing adequate care for patients in this vulnerable group," wrote the researchers from University Hospitals Cleveland Medical Center in Cleveland.
The study analyzed renal transplant data gathered by the U.S. Renal Data System (USRDS) between 2004 and 2012. USRDS is a national data system that collects and analyzes data about end-stage renal disease. Of the 105,174 recipients included in the study, 488 developed melanoma after transplantation. The median to developing melanoma was 1.45 years.
Researchers then compared their findings about melanoma rates among kidney transplant recipients with melanoma rates among the general population, gathered from data captured in the Surveillance, Epidemiology and End Results (SEER) database.
The researchers found that melanoma was 4.9 times more likely to develop in those who had received a kidney transplant than in those who did not. They also found that recipients with melanoma were 11 years older on average than were those without the cancer.
They also determined that the age of the donor could increase the recipient's risk for developing melanoma. Donors whose kidneys went to recipients who later developed melanoma were several years older than were donors whose kidneys were transplanted into patients who did not develop melanoma.
More than 96 percent of the patients with melanoma were Caucasian. At 44.7 percent versus 33.7 percent, recipients who later developed melanoma were more likely to have received a living kidney donor than were those who did not develop the skin cancer.
Taking certain medications also seems to increase the risk of melanoma. Those with melanoma were more likely to have taken sirolimus or cyclosporine — frequently-used medications to prevent rejection after organ transplant.
Recipients who took sirolimus had a 54 percent increased risk of death compared with those who did not take the medication. Patients who took cyclosporine had a 93 percent increase risk of death compared with those who did not take the anti-rejection drug.
The researchers also identified risk factors significantly affecting survival. They found that each one-year increase in recipient age is associated with a 6 percent increased risk of death, for example, and that male recipients had a 53 percent increased risk of death compared to female transplant recipients.
The results of the study also showed that those who received kidneys from living donors faced a 35 percent increased risk of death as compared with those who received organs from deceased donors. These findings are at odds with previous research that shows recipients of solid organ transplants (SOTs) from deceased donors have a greater incidence of cancer and death.
"It is believed that greater doses of immunosuppressive agents in patients with SOTs from deceased donors result in greater cancer susceptibility," wrote the scientists. "However, it is possible that patients with SOTs from living donors achieve a greater life expectancy, and older age increases melanoma risk."
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