Spectrum of Cancer Risk in Renal Transplant Recipients- A Meta-analysis

Abstract

Introduction:Renal transplant is the main modality of treatment available for end stage renal failure. There is a small risk of various types of cancers associated with renal transplant recipients due to usage of immune suppressive drugs and its consequences. Hence the purpose of this meta- analysisstudy was to determine the spectrum of cancers associatedwith renal transplant recipients.Methods:The studies which testified the incidence of cancer after renal transplantation were collected from various search engines such as Google Scholar, PubMed and EMBASE. All studies that evaluated the occurrence of cancer after renal transplantation between the years 1990-2018 were considered to be eligible for this study. Data were collected from 5 National and 5 International studies and analysed. MOOSE guidelines were used to assess the quality of the studies included in this study and reviewed briefly in RevMan version 5.3 review manager software. Statistical analysis of the included data was done using RevMan version 5.3 review manager software designed for meta-analysis and systemic review studies. Quantification of heterogeneity is done by I² value. Result:This study included 4666 recipients of kidney transplants from National studies and 8189 recipients of kidney transplants from International studies. Incidence of cancer was 61 and Non incidence of cancer was 4605 out of 4666 recipients compared in National studies, Heterogeneity chi² = 32.53 and p(<0.0001), I² =88% , Test for overall effect Z=33.99 , p(<0.0001).Forest plot comparison for the incidence of cancer after renal transplantation from International studies (figure4) which showed the risk of cancer was low. Total Confidence Interval was 95%, Incidence of cancer was 467 and Non incidence of cancer was 7722 out of 8189 recipients compared in International studies, Heterogeneity tau = 0.04 Chi = 17.24 df= 4 I = 77%(p=0.002), test for overall effect Z=26.17, p (<0.00001).Conclusion: There was two fold increase in the occurrence of cancers of stomach, oesophagus, ovary, pancreas, lung, breast, colon, and twenty fold increase in the occurrence of lympho-proliferative cancers.