ORIGINAL RESEARCH article
Front. Immunol.
Sec. Alloimmunity and Transplantation
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1626135
This article is part of the Research TopicCancer in Kidney Transplant RecipientsView all articles
Temporal trends in malignancy incidence and outcomes among kidney transplantation recipients: a multi-center real-world evidence study using the TriNetX network (2000–2010 vs. 2010–2021)
Provisionally accepted
Gu-Shun Lai*
Jian-Ri Li
Chuan-Shu Chen
Shian-Shiang Wang
Chia- Yen LinChe-Jui YangHao-Chung Ho
Sheng-Chun HungKun-Yuan Chiu
Cheng-Kuang Yang*- Taichung Veterans General Hospital, Taichung, Taiwan
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ABSTRACT Objective: Malignancy is a main cause of mortality and morbidity in kidney transplantation recipients. Advancements in cancer surveillance and treatment may contribute to increased incidence and improved clinical outcomes. This study aimed to investigate the trends and clinical outcomes of post-transplantation malignancies over the past two decades. Methods: We conducted a retrospective cohort study using the TriNetX network. Common post-transplantation malignancies were identified, and outcomes were assessed using Kaplan–Meier survival analysis with propensity score matching. We compared two transplantation cohorts (2000–2010 and 2011–2021) to assess potential changes in malignancy incidence, graft survival, and patient mortality. Results: A total of 184,267 kidney transplantation recipients were included. Compared to the general population, transplantation recipients exhibited a higher risk of malignancy [standardized incidence ratio (SIR) 1.635; 95% confidence interval (CI), 1.600–1.670] and mortality [hazard ratio (HR) 1.115; 95% CI, 1.071–1.763; P < 0.0001]. The overall incidence of post-transplantation malignancies remained stable over the past two decades. Significant reductions in graft failure (HR 0.442; 95% CI, 0.413–0.473; P < 0.0001) and all-cause mortality (HR 0.755; 95% CI, 0.713–0.801; P < 0.0001) were observed in the recent decade. Conclusion: Kidney transplantation recipients remain at increased risk for malignancies and associated mortality. While the incidence of malignancies has not changed significantly over the past two decades, both graft failure and mortality have declined in the recent decade, potentially reflecting improvements in post-transplantation care and cancer management.
Keywords: Cancer, Kidney Transplantation, outcomes, trend, Maligancy
Received: 10 May 2025; Accepted: 17 Sep 2025.
Copyright: © 2025 Lai, Li, Chen, Wang, Lin, Yang, Ho, Hung, Chiu and Yang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Gu-Shun Lai, powerxyz46@gmail.com
Cheng-Kuang Yang, yangck@icloud.com
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