05/20/2010 - Articles

Cancer risk for kidney transplant recipients is independent of immunosuppressant

By: Susan Aldridge, medical journalist, PhD

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Kidney transplant can be a lifesaving operation but it is not without long-term health risks.  In particular, those who have had a kidney transplant are more likely to develop cancer in the years after their operation.  The increased risk of cancer after a kidney transplant has been linked to the need to take immunosuppressant medication.  These drugs, as the name suggests, suppress immunity which therefore prevents rejection of the new kidney.  But the immune system plays an important role in protecting the body against cancer.  If it is suppressed then cancer is more likely.

One important question is whether some immunosuppressant drugs make cancer more likely after a kidney transplant. To answer this, researchers at The George Institute for International Health in Australia studied the incidence of cancer in 471 kidney transplant recipients in the Australian Multicentre Trial of Cyclosporine Withdrawal who received one of three different immunosuppressive regimes: azathioprine and prednisolone, cyclosporine on its own, or cyclosporine on its own followed by a switch to azathioprine and prednisolone after three months.  A total of 226 patients developed at least one cancer.  By 20 years after the kidney transplant, 27% of patients developed a non-skin cancer and 48% developed a skin cancer.  The type of treatment had no influence on the risk of cancer after a kidney transplant.  However, other risk factors were identified. Non-skin cancer was linked to increasing age and previous smoking history while skin cancer was linked to increasing age, non-brown eye color, fairer skin, and a functioning transplant.  Patients at higher risk could be more carefully monitored after their kidney transplant. It should be noted that immunosuppressive drugs have evolved since this trial was started 20 years ago, so it may be that today’s drugs for preventing organ rejection after kidney transplant are linked with a lower risk of cancer.

 

Source:

Gallagher M et al Long-term cancer risk of immunosuppressive regimens after kidney transplantation Journal of the American Society of Nephrology April 29 2010 online doi10.1681/ASN.2009101043

Created on: 05/20/2010
Reviewed on: 05/20/2010

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