1
|
Manasa T, Meyyappan V, Sandeep P, Mylarappa P, Ramesh D, Jayakumar V, Penmetsa GK. Incidence, management and treatment outcomes of renal malignancy in a post-transplant recipient at a tertiary care centre: A 16-year experience. JOURNAL OF CLINICAL UROLOGY 2022. [DOI: 10.1177/20514158221081814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction and Objective: Although the incidence of malignancy in renal transplant recipients is on the rise owing to boom in the post-transplant immunosuppressive therapy, there is paucity of literature regarding their reporting and management. In this study, we report the incidence of de novo renal malignancies, post-renal transplantation at our centre over a 16-year period and discuss their management. Methods: All patients who underwent renal transplantation at our department between March 2004 and February 2020 were included and retrospectively reviewed. We analysed the incidence of renal malignancy both in the native kidney and the graft, histological subtype, time to and type of treatment. Results: A total of 376 patients underwent renal transplantation. Mean age of recipients was 48.2 and 52.15 years among those who developed cancer. 13 (2.93%) of 376 recipients developed urogenital malignancy, of whom 8 had renal cell carcinoma (RCC) in their native kidneys and 1 in the allograft. Transitional cell carcinoma (TCC) of renal pelvis was noted in three patients with one concomitant TCC of bladder. No treatment-related graft losses occurred in the native kidney malignancy. Patients with RCC underwent nephrectomy while TCC of renal pelvis underwent nephroureterectomy with bladder cuff excision. Transurethral resection was done for bladder tumour. All patients were followed up as per standard protocol. Conclusion: A rise in urological post-transplant malignancies mandates regular surveillance after renal transplantation to ensure early detection of de novo malignancies and early initiation of treatment. Goal should be to minimise adverse graft outcomes with no compromise on oncological outcomes. Level of evidence: Not applicable
Collapse
Affiliation(s)
- T Manasa
- Department of Urology, Ramaiah Medical College, India
| | | | | | | | - D Ramesh
- Department of Urology, Ramaiah Medical College, India
| | | | | |
Collapse
|
2
|
Borin A, Violi P, Eccher A, Zaza G, Carraro A. Carcinogenesis and Cancer Progression in De Novo Anal Squamous Cell Carcinoma After Organ Transplantation: A Systematic Review. EXP CLIN TRANSPLANT 2022; 20:122-129. [PMID: 35282809 DOI: 10.6002/ect.2021.0412] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Our aim was to perform a comprehensive literature review on the pathogenesis of squamous anal cancerin patients after solid-organ transplant. Medical databases were consulted until June 1, 2020, for potentially relevant publications.All studies on pathogenesis of de novo anal squamous cell carcinoma in solid-organ transplant recipients were included. Two researchers independently performed study selection, quality assessment, and data extraction and analysis. Twenty-one studies were included.None ofthe selected papers had been solely focused on carcinogenesis. Most ofthe studies identified human papillomavirus infection and immunosuppression to be significantly correlated with the development of de novo anal cancer in adult solid organ transplant recipients. CD4+ T-cell depletion and inactivation oftumor suppressor pathways were mainly implicated. All solid-organ transplant recipients, especially those who were human papillomavirus positive, were shown to be at increased risk for the development of posttransplant anal cancer. Further studies are needed to determine the specific mechanisms of pathogenesis according to different solid-organ transplant populations.
Collapse
Affiliation(s)
- Alex Borin
- From the Department of General Surgery and Dentistry, Liver Transplant Unit, University and Hospital Trust of Verona, Verona, Italy
| | | | | | | | | |
Collapse
|
3
|
Veillette G, Castaldi M, Roberts S, Parsikia A, Choubey A, Okumura K, Latifi R, Ortiz J. Liver transplantation does not increase morbidity or mortality in women undergoing surgery for breast cancer. WOMEN'S HEALTH 2022; 18:17455057221097554. [PMID: 35638701 PMCID: PMC9160893 DOI: 10.1177/17455057221097554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose: The incidence of breast cancer following solid organ transplantation is comparable to the age-matched general population. The rate of de novo breast cancer following liver transplantation varies. Furthermore, there is limited information on the management and outcomes of breast cancer in liver transplant recipients. We aim to evaluate the impact of liver transplantation on breast cancer surgery outcomes and compare the outcomes after breast cancer surgery in liver transplant recipient in transplant versus non-transplant centers. Methods: National Inpatient Sample database was accessed to identify liver transplant recipient with breast cancer. Mortality, complications, hospital charges, and total length of stay were evaluated with multivariate logistic regression testing. Weighted multivariate regression models were employed to compare outcomes at transplant and non-transplant centers. Results: Ninety-nine women met inclusion criteria for liver transplantation + breast cancer and were compared against women with breast cancer without liver transplantation (n = 736,527). Liver transplantation + breast cancer had lower performance status as confirmed via higher Elixhauser Comorbidity Index (20.5% vs 10.2%, p < 0001). There were significantly more complications in the liver transplantation cohort when compared to the non-liver transplant recipient (15.0% vs 8.2%, p = 0.012). However, on multivariate analysis, liver transplantation was not an independent risk factor for post-operative complications following breast cancer surgery (odd ratio, 1.223, p = 0.480). Cost associated with breast cancer care was significantly higher in those with liver transplantation (2.621, p < 0.001). Breast conservation surgery in liver transplantation had shorter length of stay as compared to breast cancer alone (odds ratio, 0.568, p = 0.027) in all hospitals. Conclusion: Liver transplantation does not increase short-term mortality when undergoing breast cancer surgery. Although there were significantly more complications in the liver transplantation cohort when compared to the non-liver transplant recipient (15.0% vs 8.2%, p = 0.012), on multivariate analysis, liver transplantation was not an independent risk factor for postoperative complications following breast cancer surgery. Breast cancer management in liver transplant recipient at non-transplant centers incurred higher charges but no difference in complication rate or length of stay when compared to transplant centers.
Collapse
Affiliation(s)
- Gregory Veillette
- Department of Surgery, Westchester Medical Center, School of Medicine, New York Medical College, Valhalla, NY, USA
| | - Maria Castaldi
- Department of Surgery, Westchester Medical Center, School of Medicine, New York Medical College, Valhalla, NY, USA
| | - Sacha Roberts
- Department of Surgery, Westchester Medical Center, School of Medicine, New York Medical College, Valhalla, NY, USA
| | | | - Ankur Choubey
- Department of Surgery, The University of Toledo Medical Center, Toledo, OH, USA
| | - Kenji Okumura
- Department of Surgery, Westchester Medical Center, School of Medicine, New York Medical College, Valhalla, NY, USA
| | - Rifat Latifi
- Department of Surgery, Westchester Medical Center, School of Medicine, New York Medical College, Valhalla, NY, USA
| | - Jorge Ortiz
- Department of Surgery, Albany Medical Center, Albany, NY, USA
| |
Collapse
|
4
|
Bilgi A, Gökulu ŞG, İlgen O, Kulhan M, Akgün Kavurmacı S, Toz H, Terek MC. Cervical dysplasia after renal transplantation: A retrospective cohort study. Turk J Obstet Gynecol 2021; 18:7-14. [PMID: 33715321 PMCID: PMC7962164 DOI: 10.4274/tjod.galenos.2021.28938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Objective: Since the first days of organ transplantation, it has been accepted that solid transplant recipients have a high risk of developing cancer. Chronic immunosuppression and environmental factors play a role in cancer development in recipients. In the present study, we tried to evaluate the cumulative incidence of cervical dysplasia after renal transplantation, risk factors for disease development, and the time until high-grade dysplasia occurred. Materials and Methods: A total of 50 patients with renal transplantation who presented for gynecologic follow-up was included in the study. The medical records of the patients were reviewed until the last clinical visit, their demographic characteristics, transplant history, gynecologic history, and gynecologic examination results (cervical cytology and histology reports) were reviewed. Results: Of the 50 women in the study population, 29 (58%; 95% confidence interval: 8.8-15.9) developed cervical dysplasia after the first transplant at a median follow-up of 7.8 (range: 4.6-12.9) years. Twenty-one women with benign cervical cytology before transplantation had evidence of low-grade intraepithelial lesions + after transplant (47% of these were within 2 years after transplant). During the follow-up, 8 women (18.2%) were diagnosed as having high-grade intraepithelial lesions + (within 5 years after transplantation). Conclusion: Renal transplant patients were found to have higher abnormal cervical cytology and histology rates than the normal population.
Collapse
Affiliation(s)
- Ahmet Bilgi
- Selçuk University Faculty of Medicine, Department of Gynaecology and Obstetrics, Konya, Turkey
| | - Şevki Göksun Gökulu
- Mersin University Faculty of Medicine, Department of Gynaecology and Obstetrics, Mersin, Turkey
| | - Orkun İlgen
- Dokuz Eylül University Faculty of Medicine, Department of Gynaecology and Obstetrics, İzmir, Turkey
| | - Mehmet Kulhan
- Selçuk University Faculty of Medicine, Department of Gynaecology and Obstetrics, Konya, Turkey
| | - Seda Akgün Kavurmacı
- Ege University Faculty of Medicine, Department of Gynaecology and Obstetrics, İzmir, Turkey
| | - Hüseyin Toz
- Ege University Faculty of Medicine, Department of Internal Medicine, İzmir, Turkey
| | - Mustafa Coşan Terek
- Ege University Faculty of Medicine, Department of Gynaecology and Obstetrics, İzmir, Turkey
| |
Collapse
|
5
|
Fu W, Merola J, Malinis M, Lacy J, Barbieri A, Liapakis AH, Mulligan DC, Yoo PS. Successful treatment of primary donor-derived human herpesvirus-8 infection and hepatic Kaposi Sarcoma in an adult liver transplant recipient. Transpl Infect Dis 2018; 20:e12966. [DOI: 10.1111/tid.12966] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 06/25/2018] [Accepted: 07/09/2018] [Indexed: 12/20/2022]
Affiliation(s)
- Whitney Fu
- Departments of Surgery; Yale School of Medicine; New Haven Connecticut
| | - Jonathan Merola
- Departments of Surgery; Yale School of Medicine; New Haven Connecticut
| | - Maricar Malinis
- Departments of Medicine; Yale School of Medicine; New Haven Connecticut
| | - Jill Lacy
- Departments of Medicine; Yale School of Medicine; New Haven Connecticut
| | - Andrea Barbieri
- Departments of Pathology; Yale School of Medicine; New Haven Connecticut
| | | | - David C. Mulligan
- Departments of Surgery; Yale School of Medicine; New Haven Connecticut
| | - Peter S. Yoo
- Departments of Surgery; Yale School of Medicine; New Haven Connecticut
| |
Collapse
|
6
|
Rahatli S, Altundag O, Ayvazoglu Soy E, Moray G, Haberal M. Posttransplant Malignancies in Adult Renal and Hepatic Transplant Patients. EXP CLIN TRANSPLANT 2018; 18:470-473. [PMID: 30119617 DOI: 10.6002/ect.2018.0177] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES The risk of some cancer types increases after organ transplant compared with that shown in the general population; this has been well documented in clinical studies. With patients having longer survival and with the higher number of transplant procedures, cancer is an increasing health concern at high-volume transplant centers. Malignancy has an important effect on short- and long-term graft and patient survival. In this study, we evaluated cancer frequency during transplant patient follow-up. MATERIALS AND METHODS This single-center retrospective study included patients who underwent solid-organ transplant at the Baskent University Medical Faculty Hospital from 1997 to 2017. Renal and hepatic transplant patients older than 16 years at the time of transplant and diagnosed with cancer after transplant were included the study. In total, 1176 of 2018 renal transplant recipients and 274 of 548 hepatic transplant recipients met the inclusion criteria. RESULTS We determined that 52 of 1176 renal transplant (4.5%) and 9 of 274 hepatic transplant patients (3.3%) developed posttransplant cancer during follow-up. Of 61 total patients with cancer posttransplant, 44 were males (72.1%) and 17 were females (27.9%), with median age at transplant of 39.2 years. Overall, the incidence of cancer in transplant recipients was 4.2%. The most frequent cancers were basal and squamous skin cancers, which were seen in 18 patients (29%), and Kaposi sarcoma, which was seen in 11 patients (18%). Of the 61 patients who developed cancer, 43 (70%) were still alive at the time of this study. CONCLUSIONS Despite recent positive developments in the use of immunosuppressive drugs, posttransplant malignancy is still a health problem. Fortunately, most cancers in this patient group have good prognosis and can be cured by surgical resection. Transplant physicians should aim for early detection of these diseases.
Collapse
Affiliation(s)
- Samed Rahatli
- Department of Medical Oncology, Baskent University Faculty of Medicine, Ankara, Turkey
| | | | | | | | | |
Collapse
|
7
|
Jeong IJ, Lee SG, Kim YH, Ko BS, Lee JW, Son BH, Ahn SH, Kim HJ. Characteristics and prognosis of breast cancer after liver or kidney transplantation. Breast Cancer Res Treat 2017; 167:101-106. [DOI: 10.1007/s10549-017-4504-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 08/11/2017] [Indexed: 12/27/2022]
|
8
|
Schrem H, Schneider V, Kurok M, Goldis A, Dreier M, Kaltenborn A, Gwinner W, Barthold M, Liebeneiner J, Winny M, Klempnauer J, Kleine M. Independent Pre-Transplant Recipient Cancer Risk Factors after Kidney Transplantation and the Utility of G-Chart Analysis for Clinical Process Control. PLoS One 2016; 11:e0158732. [PMID: 27398803 PMCID: PMC4939933 DOI: 10.1371/journal.pone.0158732] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 06/21/2016] [Indexed: 12/20/2022] Open
Abstract
Background The aim of this study is to identify independent pre-transplant cancer risk factors after kidney transplantation and to assess the utility of G-chart analysis for clinical process control. This may contribute to the improvement of cancer surveillance processes in individual transplant centers. Patients and Methods 1655 patients after kidney transplantation at our institution with a total of 9,425 person-years of follow-up were compared retrospectively to the general German population using site-specific standardized-incidence-ratios (SIRs) of observed malignancies. Risk-adjusted multivariable Cox regression was used to identify independent pre-transplant cancer risk factors. G-chart analysis was applied to determine relevant differences in the frequency of cancer occurrences. Results Cancer incidence rates were almost three times higher as compared to the matched general population (SIR = 2.75; 95%-CI: 2.33–3.21). Significantly increased SIRs were observed for renal cell carcinoma (SIR = 22.46), post-transplant lymphoproliferative disorder (SIR = 8.36), prostate cancer (SIR = 2.22), bladder cancer (SIR = 3.24), thyroid cancer (SIR = 10.13) and melanoma (SIR = 3.08). Independent pre-transplant risk factors for cancer-free survival were age <52.3 years (p = 0.007, Hazard ratio (HR): 0.82), age >62.6 years (p = 0.001, HR: 1.29), polycystic kidney disease other than autosomal dominant polycystic kidney disease (ADPKD) (p = 0.001, HR: 0.68), high body mass index in kg/m2 (p<0.001, HR: 1.04), ADPKD (p = 0.008, HR: 1.26) and diabetic nephropathy (p = 0.004, HR = 1.51). G-chart analysis identified relevant changes in the detection rates of cancer during aftercare with no significant relation to identified risk factors for cancer-free survival (p<0.05). Conclusions Risk-adapted cancer surveillance combined with prospective G-chart analysis likely improves cancer surveillance schemes by adapting processes to identified risk factors and by using G-chart alarm signals to trigger Kaizen events and audits for root-cause analysis of relevant detection rate changes. Further, comparative G-chart analysis would enable benchmarking of cancer surveillance processes between centers.
Collapse
Affiliation(s)
- Harald Schrem
- General, Visceral and Transplant Surgery, Hannover Medical School, Hannover, Germany
- Core Facility Quality Management & Health Technology Assessment in Transplantation, Integrated Research and Treatment Center Transplantation (IFB-Tx), Hannover Medical School, Hannover, Germany
- * E-mail:
| | - Valentin Schneider
- Core Facility Quality Management & Health Technology Assessment in Transplantation, Integrated Research and Treatment Center Transplantation (IFB-Tx), Hannover Medical School, Hannover, Germany
| | - Marlene Kurok
- Core Facility Quality Management & Health Technology Assessment in Transplantation, Integrated Research and Treatment Center Transplantation (IFB-Tx), Hannover Medical School, Hannover, Germany
- Gynecology and Obstetrics, KRH Klinikum Nordstadt, Hannover, Germany
| | - Alon Goldis
- Core Facility Quality Management & Health Technology Assessment in Transplantation, Integrated Research and Treatment Center Transplantation (IFB-Tx), Hannover Medical School, Hannover, Germany
- Lean Six Sigma Black Belt, Amstelveen, The Netherlands
| | - Maren Dreier
- Institute of Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Hannover, Germany
| | - Alexander Kaltenborn
- Core Facility Quality Management & Health Technology Assessment in Transplantation, Integrated Research and Treatment Center Transplantation (IFB-Tx), Hannover Medical School, Hannover, Germany
- Trauma and Orthopedic Surgery, Federal Armed Forces Hospital Westerstede, Medical Service of the Federal Armed Forces, Westerstede, Germany
| | | | - Marc Barthold
- Core Facility Quality Management & Health Technology Assessment in Transplantation, Integrated Research and Treatment Center Transplantation (IFB-Tx), Hannover Medical School, Hannover, Germany
| | - Jan Liebeneiner
- Core Facility Quality Management & Health Technology Assessment in Transplantation, Integrated Research and Treatment Center Transplantation (IFB-Tx), Hannover Medical School, Hannover, Germany
| | - Markus Winny
- General, Visceral and Transplant Surgery, Hannover Medical School, Hannover, Germany
| | - Jürgen Klempnauer
- General, Visceral and Transplant Surgery, Hannover Medical School, Hannover, Germany
| | - Moritz Kleine
- General, Visceral and Transplant Surgery, Hannover Medical School, Hannover, Germany
- Core Facility Quality Management & Health Technology Assessment in Transplantation, Integrated Research and Treatment Center Transplantation (IFB-Tx), Hannover Medical School, Hannover, Germany
| |
Collapse
|
9
|
Pendón-Ruiz de Mier V, Navarro Cabello M, Martínez Vaquera S, Lopez-Andreu M, Aguera Morales M, Rodriguez-Benot A, Aljama Garcia P. Incidence and Long-Term Prognosis of Cancer After Kidney Transplantation. Transplant Proc 2015; 47:2618-21. [DOI: 10.1016/j.transproceed.2015.08.043] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 08/18/2015] [Indexed: 12/14/2022]
|
10
|
Epidemiology of post-transplant malignancy in Chinese renal transplant recipients: a single-center experience and literature review. Med Oncol 2014; 31:32. [PMID: 24908063 DOI: 10.1007/s12032-014-0032-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Accepted: 05/10/2014] [Indexed: 02/03/2023]
Abstract
This study investigated the incidence and types of post-transplant malignancy in Chinese renal transplant recipients and the risk factors associated with malignancy. Data from 3,462 patients who underwent renal transplantation at Beijing Friendship Hospital were combined with data from 26 previous reports describing malignancy rates in 27,170 Chinese renal transplant recipients. Between 1974 and 2014, 179/3,462 (5.17 %) patients who underwent renal transplantation at our center developed malignancy. The most common site of malignancy was the urinary system, and the most common type was urothelial transitional cell carcinoma. Combined data from our center and previous reports showed malignancy in 671 (2.19 %) Chinese renal transplant recipients. The ten most common malignancies were urothelial transitional cell carcinoma (n = 283), hepatocellular carcinoma (n = 68), gastrointestinal cancer (n = 63), renal cell carcinoma (n = 42), lymphoma (n = 42), lung cancer (n = 28), breast cancer (n = 19), skin cancer (n = 18), Kaposi's sarcoma (n = 12), and cervical cancer (n = 10). The incidence of post-transplant malignancy in renal transplant recipients was lower in China than the reported rates in other countries, and the most common sites of malignancy were the urinary and digestive system. The relative frequency of malignancy sites differed between northern and southern China. Renal transplant recipients on long-term immunosuppressive therapy should receive careful follow-up, including annual or biannual screening for malignancy in high-risk individuals.
Collapse
|
11
|
Tjon ASW, Sint Nicolaas J, Kwekkeboom J, de Man RA, Kazemier G, Tilanus HW, Hansen BE, van der Laan LJW, Tha-In T, Metselaar HJ. Increased incidence of early de novo cancer in liver graft recipients treated with cyclosporine: an association with C2 monitoring and recipient age. Liver Transpl 2010; 16:837-46. [PMID: 20583092 DOI: 10.1002/lt.22064] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The goal of this study was to determine the risk factors for de novo cancer after liver transplantation (LTx). Retrospective analyses were performed in 385 LTx patients who underwent transplantation between 1986 and 2007. In total, 50 (13.0%) recipients developed de novo malignancy. The cumulative incidence of de novo cancer at 1, 5, 10, and 15 years after LTx was 2.9% +/- 0.9%, 10.5% +/- 1.8%, 19.4% +/- 3.0%, and 33.6% +/- 6.8%, respectively. The standardized incidence ratio of malignancy in LTx patients compared to the general population was 2.2 (95% confidence interval: 1.6-2.8). After excluding posttransplant lymphoproliferative disorder and skin cancer, patients with de novo cancer had a significantly lower survival rate compared to recipients who remained cancer-free. The identified univariate risk factors for de novo cancer were cyclosporine A (CsA) treatment, time period of LTx, and recipient age. In multivariate analysis, only CsA treatment emerged as an independent risk factor for de novo cancer, which was attributed to more aggressive cancer types. A surprising finding was that CsA treatment specifically enhanced cancer risk in patients who underwent transplantation after 2004, when C(2) monitoring (blood concentration at 2 hours postdose) was introduced. In addition, these patients showed a significantly lower acute rejection rate, which might reflect a more robust immunosuppressive status caused by the CsA-C(2) regimen. When age was considered, only patients < or =50 years had a higher cancer rate when treated with CsA compared to treatment with tacrolimus. Our data suggest that, compared to tacrolimus treatment, CsA treatment with C(2) monitoring or in younger patients of < or =50 years is associated with a higher early de novo cancer risk after LTx.
Collapse
Affiliation(s)
- Angela S W Tjon
- Department of Gastroenterology and Hepatology, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
| | | | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Loeffelbein DJ, Szilinski K, Hölzle F. Immunosuppressive Regimen Influences Incidence of Skin Cancer in Renal and Pancreatic Transplant Recipients. Transplantation 2009; 88:1398-9. [DOI: 10.1097/tp.0b013e3181bc3b17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
|
13
|
Navarro M, López-Andréu M, Rodríguez-Benot A, Agüera M, Del Castillo D, Aljama P. Cancer Incidence and Survival in Kidney Transplant Patients. Transplant Proc 2008; 40:2936-40. [DOI: 10.1016/j.transproceed.2008.09.025] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
|