Atalah Fatih, Acarbay Aydın, Karakök Akgün, Beşiroğlu Mehmet, Kuş Fatih, Arıcı Huzeyfe, Dirim Ahmet Burak, Suleymanova Vafa, Türkmen Aydın, Yazıcı Halil
Division of Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Istanbul Medeniyet University, 34720 Istanbul, Türkiye.
Department of Medical Oncology, Ankara Atatürk Sanatoryum Eğitim ve Araştırma Hastanesi, 06290 Ankara, Türkiye.
J Clin Med. 2025 Aug 19;14(16):5858. doi: 10.3390/jcm14165858.
: Renal transplant recipients face significant long-term graft and patient loss due to post-transplant malignancies. This study aimed to characterize post-transplant malignancies, determine mortality risk factors, and evaluate patient outcomes. : This retrospective study included 2052 kidney transplant recipients who underwent transplantation between 1976 and 2019 at our institution, other national centers, or international facilities, and who had at least six months of follow-up. Regardless of the transplant center, all patients were followed exclusively at our nephrology department for post-transplant care. A comprehensive review of patient files was conducted, encompassing demographic data, malignancy type and treatment, mortality rates, tissue compatibility assessments, viral serology results, immunosuppression protocols, acute rejection history, and pre-transplant malignancies. The relationships between these variables and mortality were examined. : A total of 167 malignant events were observed in 163 patients out of 2052 renal transplant patients (7.9%). The female patients comprised 34.4% ( = 56) of the participants. Ages at transplantation and malignancy diagnosis had medians of 40.0 (13-72) and 50.0 (23-78) years, respectively. The leading malignancy was skin cancer at 30.0%, with Kaposi sarcoma at 11.3% and post-transplant lymphoproliferative disease at 10.6% following. Of the patients followed up, 58.9% (93 patients) had mortality. In univariate analysis, older age at transplant, older age at malignancy diagnosis, and male sex were associated with mortality; however, no independent predictors were identified in the multivariate model (all > 0.05), likely due to sample size limitations and inter-variable collinearity. Mortality showed statistically significant associations ( < 0.05) with increased age at transplantation, increased age at malignancy diagnosis, and male gender. : Post-transplant malignancies significantly compromise both graft longevity and patient survival. Particularly aggressive skin cancers demand heightened clinical vigilance. Early detection through regular dermatological screening, patient education, and timely biopsies must become integral to long-term transplant care protocols.
肾移植受者由于移植后发生恶性肿瘤而面临显著的长期移植物丢失和患者死亡。本研究旨在描述移植后恶性肿瘤的特征，确定死亡风险因素，并评估患者的预后。：这项回顾性研究纳入了2052例肾移植受者，他们于1976年至2019年期间在我们机构、其他国家中心或国际机构接受了移植，并且至少有6个月的随访期。无论移植中心如何，所有患者均在我们的肾病科接受专门的移植后护理随访。对患者病历进行了全面审查，包括人口统计学数据、恶性肿瘤类型和治疗、死亡率、组织相容性评估、病毒血清学结果、免疫抑制方案、急性排斥反应史以及移植前恶性肿瘤。研究了这些变量与死亡率之间的关系。：在2052例肾移植患者中，共观察到163例患者发生了167次恶性事件（7.9%）。女性患者占参与者的34.4%（n = 56）。移植时和恶性肿瘤诊断时的年龄中位数分别为40.0（13 - 72）岁和50.0（23 - 78）岁。最主要的恶性肿瘤是皮肤癌，占30.0%，其次是卡波西肉瘤，占11.3%，移植后淋巴细胞增生性疾病占10.6%。在接受随访的患者中，58.9%（93例患者）死亡。在单因素分析中，移植时年龄较大、恶性肿瘤诊断时年龄较大以及男性与死亡率相关；然而，在多变量模型中未发现独立的预测因素（所有P > 0.05），可能是由于样本量限制和变量间共线性。死亡率与移植时年龄增加、恶性肿瘤诊断时年龄增加以及男性性别之间存在统计学显著关联（P < 0.05）。：移植后恶性肿瘤显著损害移植物寿命和患者生存。特别是侵袭性较强的皮肤癌需要提高临床警惕性。通过定期皮肤科筛查、患者教育和及时活检进行早期检测必须成为长期移植护理方案的组成部分。
