Research Information System
Thesis Type: Expertise In Medicine
Institution Of The Thesis: Istanbul University, Istanbul Medical Faculty, Division of Medical Sciences , Turkey
Approval Date: 2020
Thesis Language: Turkish
Student: Fatih Atalah
Supervisor: Halil Yazıcı
Abstract:
Introduction and Aim: Post-transplant malignancies are a
significant cause of graft and patient loss in the long term after
transplantation. The aim of this study was to establish post-transplant
malignacy’s type, incidence, risk factors affecting the mortality and analyzing
the prognosis of the kidney transplantation patients followed by the
Transplantation Clinic of Istanbul Faculty of Medicine.
Material and Method: Between January 1976 and June 2019 a
total of 2052 patients underwent renal transplantation at the centers of Istanbul
Faculty of Medicine, other transplantation centers in country or
transplantation centers abroad and were followed for more than 6 months by the
Istanbul Faculty of Medicine Transplantation Clinic were included in this
study. The patients files were retrospectively screened for demographic
features, types of the malignancy, treatments of malignancy and incidence of the
mortality, tissue compatibility, viral serology, induction and maintenance
immunosuppression regimens, history of acute rejection and pretransplant
malignancies were determined and
relationship between these variables and mortality was analyzed.
Results: Malignancy was found in 158 patients (7.69%)
as 167 (8.1%) malignancy events in 2052 patients. 102 (64.5%) of the patients
were male and 56 (35.5%) were female. The mean age at the transplantation was
40.9 ± 11.9 years. The mean follow-up period was 172.9 ± 92.4 months and the
mean age at the time of malignancy was 58.6 ± 11.6 years. The most common
malignancy was skin malignancy in 48 (30.0%) patients. This was followed by
Kaposi's sarcoma in 18 (11.3%) patients and post-transplant lymphoproliferative
disease in 17 (10.6%) patients. Non-skin solid organ malignancies were detected in 52 (32.5%) patients.
Among these, 11 thyroid papillary carcinomas, 8 colon adenocarcinomas and 8
breast carcinomas were detected. 49 patients (31.0%) died. Low eGFR at the time
of diagnosis of malignancy, advanced age at transplantation, advanced age at
the time of diagnosis of malignancy and male sex were significantly higher in
the mortality group (p <0.05).
Conclusion: Post-transplant malignancies are an
important cause of graft and patient loss. Because of the higher incidence and
more aggressive course in the transplant patient group, patients should be
included in appropriate screening programs, should be informed on whole body
skin examination and biopsy should be taken from every suspicious lesion and
early diagnosis and treatment should be planned.