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Cancer, Infection Risk Higher in Transplant Patients Than Rejection

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Cancer, infection, and heart disease are greater risk factors for death in kidney transplant recipients who die with a functional graft than organ rejection, a retrospective Mayo Clinic cohort study indicates.

“It’s important to have immunosuppression to protect people from rejection but we wanted to be able to say, ‘What are the other causes of kidney failure that we might be able to identify that help improve longer-term outcomes’,” co-author Andrew Bentall, MBChB, MD, a Mayo Clinic nephrologist, told Medscape Medical News.

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Could Nixing Race-Adjustments for eGFR Harm Black Cancer Patients?

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“Removing race from estimated glomerular filtration rate (eGFR) equations would result in fewer Black patients being eligible for certain anticancer drugs, researchers have demonstrated.

Their analysis showed that for Black patients, removing race from the Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) equation reduced median eGFR from 103 mL/min to 89 mL/min. In addition, removing the race factor doubled the percentage of black patients with an eGFR under 60 mL/min — a clinically relevant cut-off below which many drugs have recommended changes to dosage and eligibility, reported Thomas D. Nolin, PharmD, PhD, of the University of Pittsburgh School of Pharmacy, and colleagues.”

Learn more here.

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PTC: Cancer Risks for Kidney Recipients

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WHY AM I AT GREATER RISK OF DEVELOPING CANCER AFTER KIDNEY TRANSPLANT?

“All organ transplant recipients are at heightened risk of developing cancer after transplant. This is because although life-sustaining, long-term use of immunosuppressant drugs lowers the body’s ability to fend off certain cancers. When you are taking immunosuppressant drugs, your immune response is lowered, and this is what helps to prevent your body from rejecting your new kidney. It also means that your body is less able to recognize and destroy cancer cells or infections that can cause cancer.”

Read more on TRIO’s new Post-transplant Cancer Project (PTC) website, here.

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How Common is Cancer in Organ Transplant Recipients?

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As an organ transplant recipient, you already “know” several things:

  • You know what the anxiety and stress of end-stage organ disease feels like
  • You know that your life has been improved after receiving your transplant
  • You know that by taking care of your transplant, you can reduce the risk of rejection of the organ

Did you also know that the important immunosuppressants (anti-rejection medications) you take to prevent your body from rejecting your transplanted kidney, heart, lung, or liver may increase your risk of developing certain types of
cancer?1

While the risk of dying from cancer is low, you need to be proactive and get screened for various types of cancer—most notably skin cancer.

Read the full article, here.

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Cancer Patients and Transplant Recipients Need Both COVID-19 Vaccine Doses

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“Natural immunity and vaccine responses may be weaker in people with immune suppression, so they should get their second dose promptly

A majority of people with cancer and organ transplant recipients are capable of mounting an immune response to the SARS-CoV-2 coronavirus and can gain immunity from COVID-19 vaccines, according to recent research. But people with immune suppression may have slower and weaker responses to natural infection or vaccination, so it is especially important that they get their second dose on schedule.

People with serious immune suppression are at risk for more severe complications and death due to COVID-19. This group includes cancer patients who use immune-suppressing therapy, transplant recipients who take immunosuppressive drugs to prevent organ rejection and people with AIDS (advanced, uncontrolled HIV disease).

It is well known that immunosuppressed people can have weaker immune responses to natural infection and vaccination, but SARS-CoV-2 immunity in this population is not well understood. What’s more, cancer patients on treatment and other people with advanced immune suppression were generally excluded from COVID-19 vaccine trials (though people with well-controlled HIV could enroll).”

Read the full article, here.

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