Cancer Risk After Pediatric Solid Organ Transplantation.

Cancer Risk After Pediatric Solid Organ Transplantation.
Solid organ transplant (SOT) recipients are known to have a higher risk of cancer, in particular NHL and HL. Previous studies to better understand pediatric PTLD were done in single centre settings.
This study linked the scientific registry of transplant recipients (captures all solid organ transplants in US) with 16 US state or regional central cancer registries (described as reliably capturing all cancer diagnosis, except basal cell and squamous cell carcinoma of the skin) to identify pediatric transplant recipients in the US from 1987-2011.
Pediatric solid organ transplant patients had an increased risk of cancer (>19 times higher) compared to general population. Cancers included: NHL (212 times higher), Hodgkin’s lymphoma (19 times higher), leukemia (4 times higher), myeloma, cancers or liver, soft tissue, ovary, vulva, testis, bladder, kidney and thyroid. No increased incidence of brain or bone cancers was found. Risk of NHL was highest during first year, in EBV negative recipients, intestine transplant, and induction immunosuppression.
Limited by the quality and amount of data entered into the registries (example EBV serostatus missing for 52% of included transplants). Oldest age at follow up was 38 years of age, thus we don’t know the risk of cancer later in life for pediatric SOT recipients.
Pediatric Solid organ transplant recipients have a significantly higher risk of cancer (in particular NHL, HL) but also many cancer types including leukemias and solid tumours compared to general population (and adult SOT recipients).