DETROIT - African-American kidney transplant recipients develop non-skin cancers more frequently than Caucasian patients, Wayne State University School of Medicine researchers have found.
The findings, published in the April issue of Renal and Urology News, hold important implications for how black kidney transplant recipients are educated about their treatment and their post-operative protocols.
The team noted that physicians have known for quite some time that white kidney recipients demonstrate greater risk for developing skin cancer when compared against the general population. However, this is the first study to find that black patients develop more types of cancers and at significantly greater rates than white patients after receiving a kidney transplant.
The WSU study involved 495 adult black kidney recipients who received their transplants at Harper University Hospital between January 1984 and December 2007. The team compared their patients with 11,155 white kidney recipients in the Canadian Organ Replacement Registry. The incidence of prostate, kidney, pancreatic and esophageal cancers was significantly higher among black kidney recipients.
The research team included Scott Gruber, M.D., Ph.D., M.B.A., professor of surgery and chief of the Section of Transplant Surgery for the Wayne State University School of Medicine; Atul Singh, M.D., assistant professor of internal medicine, Division of Nephrology; Kalyani Mehta, M.D., assistant professor of internal medicine, Division of Nephrology; Miguel West, M.D., associate professor of surgery, Section of Transplant Surgery; Mona Doshi, M.D., assistant professor of internal medicine; Division of Nephrology; and Katherina Morawski, R.N., Department of Internal Medicine, Division of Nephrology.
Dr. Gruber, the lead author who presented the team's findings at the recent Central Surgical Association's 66th annual meeting in Chicago, said this is the first study to detail the types of non-skin cancers that are more common in black transplant recipients. He served as program chair of the meeting and presented "Different patterns of cancer incidence among African-American and Caucasian renal allograft recipients."
Dr. Gruber , director of the Organ Transplant Program at Harper University Hospital, said it is not the kidney transplant that makes patients more susceptible to cancers, but the drugs that patients must take to suppress their immune systems to prevent rejection of the kidney weakens the body's defenses.
The team's findings can be partly attributed to geography, Dr. Gruber said. "At our transplant center, 84 percent of our kidney transplant recipients are African-American," he said. "They stay here after the transplant and remain our patients, so we can follow them."
In other areas of the United States, he said, patients may travel hundreds of miles to receive a kidney transplant, and then return home to be treated by their local nephrologist, losing their connection with the transplant center. In the southeast Michigan region, patients remain in the area and are seen continuously by physicians on the WSU transplant team, who can follow their patients for longer periods and record incidents of cancer development.
Wayne State University is a premier urban research university offering more than 350 academic programs through 13 schools and colleges to nearly 32,000 students.
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