{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T15:50:08Z","timestamp":1753890608483,"version":"3.41.2"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,4,3]],"date-time":"2023-04-03T00:00:00Z","timestamp":1680480000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>Chronic kidney disease (CKD) pre-heart transplantation (HTx) has been proposed as a risk factor for malignancy risk post-HTx. Using multicenter registry data, our aim was to calculate the death-adjusted annual incidence of malignancies post-HTx, corroborate the association between CKD pre-HTx and malignancy risk post-HTx, and determine other risk factors for post-HTx malignancies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and materials<\/jats:title><jats:p>We used data from patients transplanted in North American HTx centers between January 2000 and June 2017 and registered in the International Society for Heart and Lung Transplantation Thoracic Organ Transplant Registry. We excluded recipients with missing data on post-HTx malignancies, heterotopic heart transplant, retransplantation, multi-organ transplantation, and patients with a total artificial heart pre-HTx.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 34,873 patients were included to determine the annual incidence of malignancies, 33,345 patients were included in the risk analyses. The incidence of any malignancy, solid-organ malignancy, post-transplant lymphoproliferative disease (PTLD), and skin cancer adjusted for death 15 years post-HTx, was 26.6%, 10.9%, 3.6%, and 15.8% respectively. Besides widely acknowledged risk factors, CKD stage \u22654 pre-HTx was associated with the development of all malignancies post-HTx (HR 1.17 compared to CKD stage 1, <jats:italic>p<\/jats:italic>\u2009=\u20090.023), as well as solid-organ malignancies (HR 1.35, <jats:italic>p<\/jats:italic>\u2009=\u20090.01), but not for PTLD (HR 0.73, <jats:italic>p<\/jats:italic>\u2009=\u20090.057), and skin cancer (HR 1.06, <jats:italic>p<\/jats:italic>\u2009=\u20090.59).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Risk of malignancy post-HTx remains high. CKD stages \u22654 pre-HTx was associated with an increased risk for any malignancy and solid-organ malignancy post-HTx. Strategies to mitigate the impact of pre-HTx patient factors on the risk of post-HTx malignancy are needed.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2023.1145996","type":"journal-article","created":{"date-parts":[[2023,4,3]],"date-time":"2023-04-03T05:23:48Z","timestamp":1680499428000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Influence of chronic kidney disease and other risk factors pre-heart transplantation on malignancy incidence post-heart transplantation"],"prefix":"10.3389","volume":"10","author":[{"given":"Stefan","family":"Roest","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammed T.","family":"G\u00fcrg\u00f6ze","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wida S.","family":"Cherikh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Josef","family":"Stehlik","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric H.","family":"Boersma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felix","family":"Zijlstra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivier C.","family":"Manintveld","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,4,3]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1016\/j.jacc.2016.04.053","article-title":"Heart failure after myocardial infarction is associated with increased risk of cancer","volume":"68","author":"Hasin","year":"2016","journal-title":"J Am Coll Cardiol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1002\/ejhf.472","article-title":"Incidence of cancer in patients with chronic heart failure: a long-term follow-up study","volume":"18","author":"Banke","year":"2016","journal-title":"Eur J Heart Fail"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1501","DOI":"10.1016\/j.jacc.2018.01.069","article-title":"Lack of association between heart failure and incident cancer","volume":"71","author":"Selvaraj","year":"2018","journal-title":"J Am Coll Cardiol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"678","DOI":"10.1161\/CIRCULATIONAHA.117.030816","article-title":"Heart failure stimulates tumor growth by circulating factors","volume":"138","author":"Meijers","year":"2018","journal-title":"Circulation"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1452","DOI":"10.1038\/s41591-020-0964-7","article-title":"Myocardial infarction accelerates breast cancer via innate immune reprogramming","volume":"26","author":"Koelwyn","year":"2020","journal-title":"Nat Med"},{"key":"B6","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1016\/j.jaccao.2020.12.003","article-title":"Cardiovascular risk factors are associated with future cancer","volume":"3","author":"Lau","year":"2021","journal-title":"JACC CardioOncol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1002\/ejhf.30","article-title":"Co-morbidities in patients with heart failure: an analysis of the European heart failure pilot survey","volume":"16","author":"van Deursen","year":"2014","journal-title":"Eur J Heart Fail"},{"key":"B8","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1053\/j.ackd.2019.01.004","article-title":"Immune dysfunction and risk of infection in chronic kidney disease","volume":"26","author":"Syed-Ahmed","year":"2019","journal-title":"Adv Chronic Kidney Dis"},{"key":"B9","doi-asserted-by":"publisher","first-page":"738","DOI":"10.1038\/nri3523","article-title":"The immune system and kidney disease: basic concepts and clinical implications","volume":"13","author":"Kurts","year":"2013","journal-title":"Nat Rev Immunol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1056","DOI":"10.1016\/j.healun.2019.08.004","article-title":"The international thoracic organ transplant registry of the international society for heart and lung transplantation: thirty-sixth adult heart transplantation report\u20142019; 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