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NDT Advance Access published online on October 10, 2009
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfp497
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© The Author 2009. Published by Oxford University Press [on behalf of ERA-EDTA]. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


Malignancy incidence after renal transplantation in children: a 20-year single centre experience

Foteini Koukourgianni1, Jérôme Harambat1, Bruno Ranchin1, Sylvie Euvrard2, Raymonde Bouvier3, Aurélia Liutkus1 and Pierre Cochat1

1 Centre de référence des Maladies Rénales Rares, Hôpital Femme Mère Enfant et Université de Lyon 2 Service de Dermatologie, Hôpital Edouard Herriot 3 Service d’Anatomopathologie, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Lyon France

Correspondence and offprint requests to: Pierre Cochat; E-mail: pierre.cochat{at}chu-lyon.fr



  Abstract

Background. Cancer is a well-recognized complication of organ transplantation. The pattern of malignancies that occur in the paediatric graft population is different from that in the general paediatric population and in the population of adult organ transplant recipients.

Methods. We reviewed medical records from 240 consecutive paediatric renal transplantations performed in 219 children, aged less than 19 years, in our centre between April 1987 and March 2007. Data from patients who had been transferred into adult units were extracted from the French registries of dialysis and transplantation.

Results. Among the 219 children who underwent renal transplantation during the study period, 16 (7.3%) developed malignancy. The cumulative incidence of cancer was 1.9, 4.0, 6.9 and 10.2% at 1, 5, 10 and 15 years post-transplantation, respectively. The 10-year incidence of post-transplantation lymphoproliferative disorder (PTLD) was 4.5%. Other identified cancers were Hodgkin lymphoma, Burkitt lymphomas, renal papillary carcinoma, thyroid papillary carcinoma, recurrent ovarian seminoma and skin cancer. The mortality rate was 25% (4/16).

Conclusion. Early detection of cancer in transplant recipients is of great importance. Regular screening for persistent Epstein–Barr virus (EBV) DNA viral load in patients at risk for developing PTLD is recommended. The occurrence of skin cancer in transplanted children is extremely rare during childhood, but cases can develop in early adulthood.

Keywords: child; malignancy; post-transplantation lymphoproliferative disease (PTLD); renal transplantation; skin cancer

Received for publication: 18. 1.09
Accepted in revised form: 27. 8.09


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