Besarani Dler, Cranston David
Department of Urology, Churchill Hospital, Oxford Radcliffe Hospitals NHS Trust, Oxford, UK.
BJU Int. 2007 Sep;100(3):502-5. doi: 10.1111/j.1464-410X.2007.07049.x.
Immunosuppression in solid-organ recipients is associated with a greater risk of de novo malignancy after transplantation; herein we report the UK transplant registry (UKTR) database of urological cancer after renal transplantation in the UK transplant population. From September 1999 to January 2006 there were 10,847 kidney recipients with at least one period of follow-up reported after a kidney transplant (mean age at transplantation 42.4 years, sd 15.5; 6685 male, 61.6%, and 4162 female, 38.3%). The recipients represent a homogenous group who received different immunosuppression regimens. Skin cancer was excluded from the study. Unfortunately, the UKTR does not collect information about the presence or absence of cancer, either at registration onto the transplant waiting list or at transplantation. In all, 214 (1.9%) patients were reported to have a subsequent urological malignancy diagnosed among the 10,847 recipients. The UKTR was used to identify patients who developed urological malignancies after renal transplantation, which is a challenging event after solid-organ transplantation. Regular surveillance to diagnose early occurrence and adjustment of immunosuppression might be beneficial. In the presence of metastatic disease, chemotherapy treatment with adjustment or cessation of immunosuppressive therapy is required.
实体器官移植受者的免疫抑制与移植后新发恶性肿瘤的风险增加相关；在此我们报告英国移植人群肾移植后泌尿系统癌症的英国移植登记处（UKTR）数据库。1999年9月至2006年1月，有10847名肾移植受者在肾移植后至少有一段随访期报告（移植时平均年龄42.4岁，标准差15.5；男性6685名，占61.6%，女性4162名，占38.3%）。这些受者代表了接受不同免疫抑制方案的同质群体。本研究排除了皮肤癌。遗憾的是，UKTR在移植等待名单登记或移植时均不收集有关癌症存在与否的信息。在10847名受者中，共有214名（1.9%）患者报告随后被诊断患有泌尿系统恶性肿瘤。UKTR用于识别肾移植后发生泌尿系统恶性肿瘤的患者，这在实体器官移植后是一个具有挑战性的事件。定期监测以诊断早期发病并调整免疫抑制可能有益。在存在转移性疾病的情况下，需要在调整或停止免疫抑制治疗的同时进行化疗。
