Previous Cancers Linked to Higher Rates for Death and New Cancers in Organ Transplantation Recipients

People who had had cancer before an organ transplant are more likely to die of any cause or of cancer, or to develop a new cancer than people had not had cancer before an organ transplant. Notably, the increased risk is lower than some previous studies reported.1

This research confirms that cancer survivors have a higher mortality rate and a higher rate of new cancer than organ recipients with no history of cancer, said Sergio Acuna, MD, a physician and PhD student in clinical epidemiology at St. Michael's Hospital in Toronto, Ontario, Canada, and lead author of the study. The type of organ transplanted did not affect the association between higher rates of death, death from cancer, and new cancers.

The study was a meta-analysis of 33 cohort studies involving almost 400 000 patients in 12 countries. Risk of death for transplant recipients who were cancer survivors was approximately 1.5 times higher at any given time than for recipients who had no previous cancer. In addition, transplant recipients who were cancer survivors had about 3x more risk of dying from cancer and almost 2x more risk of developing a new cancer.

Acuna explained that the study did not examine if the association between higher deaths, higher deaths from cancer, and the development of new cancers was caused by characteristics of the organ donor or some other factor such as the type of immunosuppressant drug. Previous studies have found that transplant recipients with previous cancers were more likely to have received organs from expanded criteria donors (older donors who may have had medical conditions such as high blood pressure, or who died as a result of a stoke), or to have spent prolonged time on dialysis. Both of these are factors associated with deaths from cardiovascular incidents, such as a heart attack or stroke, and rejection of a transplanted organ.

Reference

1. Acuna SA, Huang JW, Daly C, et al. Outcomes of solid organ transplant recipients with preexisting malignancies in remission [published online ahead of print April 20, 2016]. Transplantation. doi:10.1097/TP.0000000000001192.

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