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Risk of Cancer in Retransplants Compared to Primary Kidney Transplants in the United States
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    Recipients of kidney transplantation have elevated risk of developing cancer. There are limited data on cancer risk in recipients of kidney retransplantation. We used data from the Transplant Cancer Match Study, which links the U.S. transplant registry with 15 cancer registries. Cancer incidence in recipients of kidney retransplantation and primary kidney transplants was compared utilizing Poisson regression, adjusting for demographic and medical characteristics. We assessed 109 224 primary recipients and 6621 retransplants. Compared to primary recipients, retransplants were younger (median age 40 vs. 46 yr), had higher PRA, and more often received induction with polyclonal antibodies (43% vs. 25%). A total of 5757 cancers were observed in primary recipients and 245 in retransplants. Overall cancer risk was similar in retransplants compared with primary recipients (incidence rate ratio [IRR] 1.06, 95% CI 0.93-1.20, adjusted for age, gender, race/ethnicity, PRA, and use of polyclonal induction). However, renal cell carcinoma (RCC) occurred in excess among retransplants (adjusted IRR 2.03, 95% CI 1.45-2.77), based on 514 cases in primary recipients and 43 cases in retransplants. Overall cancer risk did not differ in retransplants compared to primary recipients. Increased risk of RCC may be explained by the presence of acquired cystic kidney disease, which is more likely to develop with additional time with kidney disease and time spent on dialysis waiting for retransplantation.

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    5658DP000805-04/DP/NCCDPHP CDC HHS/United States
    5U58/DP003931-02/DP/NCCDPHP CDC HHS/United States
    5U58DP000812-03/DP/NCCDPHP CDC HHS/United States
    5U58DP000824-04/DP/NCCDPHP CDC HHS/United States
    5U58DP003875-01/DP/NCCDPHP CDC HHS/United States
    HHSH234200537009C/PHS HHS/United States
    HHSH250201000018C/PHS HHS/United States
    HHSN261201000024C/PHS HHS/United States
    HHSN261201000026C/PHS HHS/United States
    HHSN261201000034C/PHS HHS/United States
    HHSN261201000035C/PHS HHS/United States
    HHSN261201000036C/PHS HHS/United States
    HHSN261201000037C/PHS HHS/United States
    HHSN261201300021I/PHS HHS/United States
    HSN261201000032C/PHS HHS/United States
    N01-PC-2013-00021/PC/NCI NIH HHS/United States
    N01-PC-35137/PC/NCI NIH HHS/United States
    N01-PC-35139/PC/NCI NIH HHS/United States
    N01-PC-35142/PC/NCI NIH HHS/United States
    N01-PC-35143/PC/NCI NIH HHS/United States
    U58 DP000848-04/DP/NCCDPHP CDC HHS/United States
    U58DP000832/DP/NCCDPHP CDC HHS/United States
    U58DP003879/DP/NCCDPHP CDC HHS/United States
    Z01 CP010150-09/Intramural NIH HHS/United States
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