Wang Zhipeng, Deng Lihong, Hou Wen, Liu Shiyu, Zhang Yacong, Sheng Chao, Zhang Yu, Li Jun, Shen Zhongyang
Institute of Transplantation Medicine, Tianjin First Central Hospital, Nankai University, Tianjin 300192, China.
Institute of Preventive Medicine, Tianjin Centers for Disease Control and Prevention, Tianjin 310011, China.
Prev Med. 2024 Dec;189:108161. doi: 10.1016/j.ypmed.2024.108161. Epub 2024 Nov 2.
To evaluate the cancer mortality risk among solid organ transplant recipients through a systematic review and meta-analysis.
Systematic searches were conducted in PubMed (starting from 1965), ISI Web of Science (starting from 1900), MEDLINE (starting from 1976), and Scopus (starting from 1968) from the inception of each database until July 15, 2024. Studies published in English reporting at least one type of cancer mortality risk among recipients of any type of solid organ transplantation were included. The main outcomes were the standardized mortality ratio (SMR) for cancer mortality in transplant recipients compared to the general population, and the hazard ratio (HR) for cancer mortality in transplant recipients versus cancer patients without prior transplantation.
Solid organ transplant recipients had a 2.06-fold increased cancer mortality risk (SMR, 2.06 [95 % CI, 1.56-2.71]) than the general population. Risks were higher in kidney (SMR 1.92 [95 % CI: 1.30-2.84]), liver (SMR 3.07 [95 % CI: 1.80-5.24]), and lung/heart (SMR 4.87 [95 % CI: 3.33-7.12]) transplant recipients. Cancer patients with prior transplantation had a 1.47-fold increased cancer mortality risk (HR 1.47 [95 % CI: 1.29-1.68]) than those without. East Asia female transplant recipients exhibited higher mortality risks from breast, ovarian, cervix and uterus cancers than those from other regions (SMR 3.13 [95 % CI: 1.93-5.07] vs. 1.16 [95 % CI: 0.88-1.53], P < 0.01).
Solid organ transplant recipients face significantly higher cancer mortality risks than the general population, highlighting the need for targeted cancer screening and interventions, especially for female solid organ transplant recipients from East Asia.
通过系统评价和荟萃分析评估实体器官移植受者的癌症死亡风险。
从每个数据库创建之初至2024年7月15日，在PubMed（从1965年开始）、ISI Web of Science（从1900年开始）、MEDLINE（从1976年开始）和Scopus（从1968年开始）中进行系统检索。纳入以英文发表的、报告了任何类型实体器官移植受者中至少一种癌症死亡风险的研究。主要结局是移植受者与一般人群相比的癌症死亡标准化死亡比（SMR），以及移植受者与未接受过移植的癌症患者相比的癌症死亡风险比（HR）。
实体器官移植受者的癌症死亡风险比一般人群高2.06倍（SMR，2.06 [95% CI，1.56 - 2.71]）。肾移植受者（SMR 1.92 [95% CI：1.30 - 2.84]）、肝移植受者（SMR 3.07 [95% CI：1.80 - 5.24]）和肺/心脏移植受者（SMR 4.87 [95% CI：3.33 - 7.12]）的风险更高。既往接受过移植的癌症患者的癌症死亡风险比未接受过移植的患者高1.47倍（HR 1.47 [95% CI：1.29 - 1.68]）。东亚女性移植受者患乳腺癌、卵巢癌、宫颈癌和子宫癌的死亡风险高于其他地区的女性（SMR 3.13 [95% CI：1.93 - 5.07] 对比 1.16 [95% CI：0.88 - 1.53]，P < 0.01）。
实体器官移植受者面临的癌症死亡风险显著高于一般人群，这凸显了进行针对性癌症筛查和干预的必要性，特别是对于来自东亚的女性实体器官移植受者。
