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Review
. 2024 Jan;44(1):151501.
doi: 10.1016/j.semnephrol.2024.151501. Epub 2024 Apr 4.

Pediatric Kidney Transplantation: Cancer and Cancer Risk

Kaitlyn E Order  1 , Nancy M Rodig  2
Affiliations
Review

Pediatric Kidney Transplantation: Cancer and Cancer Risk

Kaitlyn E Order et al. Semin Nephrol. 2024 Jan.

Abstract

Children with end-stage kidney disease (ESKD) face a lifetime of complex medical care, alternating between maintenance chronic dialysis and kidney transplantation. Kidney transplantation has emerged as the optimal treatment of ESKD for children and provides important quality of life and survival advantages. Although transplantation is the preferred therapy, lifetime exposure to immunosuppression among children with ESKD is associated with increased morbidity, including an increased risk of cancer. Following pediatric kidney transplantation, cancer events occurring during childhood or young adulthood can be divided into two broad categories: post-transplant lymphoproliferative disorders and non-lymphoproliferative solid tumors. This review provides an overview of cancer incidence, types, outcomes, and preventive strategies in this population.

Keywords: Cancer; kidney transplant; pediatric; post-transplant lymphoproliferative disorder.

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Conflict of interest statement

Financial disclosure and conflict of interest statements: none.

Figures

Figure 1.
Figure 1.
Time to first cancer following kidney transplantation in childhood stratified by type and adjusted for competing risk of death. Reprinted with permission.
Figure 2.
Figure 2.
Incidence of PTLD among pediatric kidney transplant recipients by recipient EBV status at transplant, 2010-2016. Abbreviations: EBV, Epstein-Barr virus; PTLD, post-transplant lymphoproliferative disorder. Reprinted with permission. OPTN/SRTR 2021 Annual Data Report
Figure 3.
Figure 3.
Kaplan-Meier calculated patient survival following PTLD diagnosis stratified by era of PTLD diagnosis. Abbreviation: PTLD, post-transplant lymphoproliferative disorder. Reprinted with permission.
See this image and copyright information in PMC

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