Wang Min, Zhang Huai, Zhou Dan, Qiao Yong-Chao, Pan Yan-Hong, Wang Yan-Chao, Zhao Hai-Lu
Center for Diabetic Systems Medicine, Guangxi Key Laboratory of Excellence, Guilin Medical University, Guilin, 541004, Guangxi, China.
School of Public Health, Guilin Medical University, Guilin, 541004, Guangxi, China.
J Cancer Res Clin Oncol. 2018 Mar;144(3):543-550. doi: 10.1007/s00432-018-2590-z. Epub 2018 Jan 22.
Malignancy following renal transplantation remains inconsistent with the reported safety of kidney donation during the long-term follow-up.
We conducted searches of the published literature which included healthy participants, recipients, living kidney donors (LKDs), and the availability of outcome data for malignancy. Eight from 938 potentially relevant studies were analyzed by means of fixed-effects model or random-effects model, as appropriately.
In 48,950 participants, the follow-up range was 18 months to 20 years, and the mean age of the subjects was approximately 41 years. The incidence rate with 95% confidence interval (CI) for malignancy after kidney transplantation was 0.03 (0.01-0.05) in recipients and 0.03 (0.1-0.07) in LKDs, giving a pooled incidence rate of 0.03 (95% CI 0.02-0.04). LKDs contrasted nondonors by the overall odds ratio and 95% CI for total cancer of 2.80 (2.69-2.92).
Kidney transplantation was associated with an increased risk of cancer during a long-term follow-up. Long-term risk for cancer in LKDs and kidney recipients should be monitored.
肾移植后的恶性肿瘤情况与长期随访中所报告的肾捐赠安全性不一致。
我们对已发表的文献进行检索，这些文献涵盖健康参与者、受者、活体肾供者（LKDs）以及恶性肿瘤结局数据的可得性。对938项潜在相关研究中的8项进行了适当的固定效应模型或随机效应模型分析。
在48,950名参与者中，随访时间为18个月至20年，受试者的平均年龄约为41岁。肾移植后恶性肿瘤的发病率及95%置信区间（CI）在受者中为0.03（0.01 - 0.05），在活体肾供者中为0.03（0.01 - 0.07），合并发病率为0.03（95% CI 0.02 - 0.04）。活体肾供者与非供者相比，总体癌症比值比及95% CI为2.80（2.69 - 2.92）。
在长期随访中，肾移植与癌症风险增加相关。应监测活体肾供者和肾受者的长期癌症风险。
