Introduction The mTOR inhibitor is an immunosuppressive drug used in kidney transplantation. Whether the mTOR inhibitors is associated with reduced risk of cancer development in Chinese population is unknown. Methods We conducted a nationwide population-based study. Patients who did not have malignancy history and received kidney transplantation between 2000-2013 were enrolled. A total of 3628 patients were included. We conducted a propensity score matching to determine 793 recipients who had mTOR inhibitors > 30 days as the study group; 2835 recipients who did not have mTOR inhibitors as the control group. We calculated the cumulative tablets of Sirolimus (Rapamune ® 1mg, Pfizer) or Everolimus (Certican ® 0.5mg, Novartis) within the first year of kidney transplantation. The primary outcome is the development of cancer after kidney transplantation. A Cox proportional hazard model was applied to investigate the risk of cancer development. Results Among the 78-month median duration of observation, patients who received mTOR inhibitors were not associated with lower risk of cancer development. (Adjusted HR 0.94, 95% CI 0.75-1.16, P=0.74) We found patients who had lower doses of mTOR inhibitors (<330 tablets within the first year of kidney transplantation) were associated with higher risk of cancer development (HR 1.38, 95% CI 1.06-1.78, P=0.02); but higher doses of mTOR inhibitors did not carry a lower risk of cancer development. (HR 1.13, 95% CI 0.84-1.52, P=0.43). Conclusions The mTOR inhibitors was not associated with reduced risk of cancer development in kidney transplantation recipients in Chinese population. Lower doses of mTOR inhibitors within the first year of kidney transplantation may carry a worse outcome.
|Publication status||Published - 2016|