Identification of Risk Factors Associated With Neoplastic Complications After Renal Transplantation in Nord-Pas de Calais , Normandy and Picardy Regions

Study Overview
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Brief Summary
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Kidney transplantation is now the treatment of choice for end-stage renal disease (ESRD). Between 2800 and 3000 kidney transplants are performed each year in France and more than 33 000 patients are living with a functioning graft. Preventing allograft rejection requires the use of immunosuppressive therapy, the intensity decreases as the distance from the day of transplantation. Unfortunately, treatment favors certain complications, including infectious and neoplastic. These represent a major cause of mortality in these patients. If the frequency of skin cancer is greatly increased in this population, that of solid tumors remains a concern. Approximately 20% of patients develop cancer after 10 years of graft , half non- skin cancers, the main risk factor is immunosuppressive therapy . The aim of the study is to evaluate, in a large population of patients treated in 4 regions ( the Nord-Pas de Calais, the Upper and Lower Normandy and Picardy) risk factors (in particular the nature of the immunosuppressive treatment) of developing a neoplastic complication, skin cancers and solid tumors, after renal transplantation.

Detailed Description
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A retrospective analysis of the previous 10 years, from 2002 to 2011 will be conducted. This study will better understand the epidemiology of these complications but also allow to identify risk factors associated, including demographic, environmental and related to immunosuppressive therapy. Thereafter, we hope to implement preventive measures or prospective studies, allowing us to reduce the prevalence of this complication.

Official Title
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Identification of Key Risk Factors Associated With Neoplastic Complications After Renal Transplantation in Nord-Pas de Calais, Normandy and Picardy Regions

Conditions
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Cancer of Kidney

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All adult renal transplant patients in the 4 centers of interregion North - West Patients transplanted during the period from 1 January 2002 and 31 December 2011 Patients recipients of first, second or third renal transplantation Patients transplant recipients from a living or deceased donor whatever the immunological risk Eligible patients will be included after being informed by their doctor and after accepting their data to be processed in the framework of this study Patient with a health insurance coverage Exclusion Criteria: Patients transplanted as child Patients transplanted before 1 January 2002 Patients followed in the interregion but transplanted in another center Patients recipients of a double transplant (two kidneys or kidney plus other organ) Patients that do not accept their medical data to be included in the database

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Kidney Transplantation<br>Patients who had undergone renal transplantation for 10 years in the interregion Northwest (Normandy, Picardy and Nord-Pas de Calais). | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Association between neoplastic complications and cancers | Correlation, in a population of renal transplant patients followed in interregion Northwest, of the association of neoplastic complications after renal transplantation, skin cancers and solid tumors outside the non-Hodgkin's lymphoma and the terms of immunosuppressive treatment used | 10 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Risk factors | Identify the main risk factors for developing cancer after transplantation, besides immunosuppressive therapy | 10 years | 
| Incidence | Evaluate the incidence of neoplastic complications after renal transplantation in interregion Northwest | 10 years | 
| Typology of cancers | Assess the distribution and respective frequency of different types of cancer, skin and solid tumors in this group of patients | 10 years | 
| Survival prognosis | Establish the prognosis and survival of transplanted patients with a diagnosis of cancer after transplantation | 10 years | 
| Survival factors | Analyze the factors associated with the survival of transplanted patients who developed cancer after transplantation | 10 years | 
| Graft survival | Evaluate graft survival in the group of patients who develop post- transplantation cancer , especially after cancer diagnosis | 10 years | 
| Rejection number | Determine the number of cellular acute rejection and humoral rejections in patients who developed cancer and those free from this complication and analyze the prevalence of releases in the period following the diagnosis of cancer | 10 years | 
| Renal function after cancer | To analyze the evolution of renal function after cancer diagnosis | 10 years | 
| Cancer management | Analyze the management of these cancers, in particular as regards the strategy of immunosuppressive therapy after cancer diagnosis | 10 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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grafting kidney, Cancer