Renal transplant recipients suffer significantly more complications but not mortality after breast cancer surgery and benefit from treatment at transplant centers

Abstract

Background: Breast carcinoma has the highest incidence of any cancer in adult females. The impact of a previous kidney transplant (KT) on breast cancer surgery outcomes has not been examined. We aim to evaluate the influence of a KT on the short-term outcomes of mastectomy or lumpectomy to inform future treatment decisions in this population. Methods: A retrospective cohort analysis was conducted using Nationwide Inpatient Sample (NIS) data between 2005 and 2014. Population included adult females with KT surgically treated for breast malignancy. Weighted multivariate regression models were employed to compare outcomes at transplant and nontransplant centers. Results: Three hundred and ninety-eight women met the inclusion criteria. KT recipients (KTR) had higher Elixhauser Comorbidity Index (ECI). We noted longer length of stay (P<0.001), higher expenditure (P=0.001), and complications (P<0.001). Specifically, rates of hematomas (P=0.041), acute renal failure (P<0.001), blood transfusion (P<0.001), fresh frozen plasma transfusion (P<0.001), cardiovascular (P<001), and other complications (P=0.012) were increased. There was no mortality in transplant recipients. Weighted multivariate analyses highlight that rates of complication (P=0.040), and length of stay (P<0.001) are lower at transplant centers (TCs). Conclusions: History of KT has a significant impact on the outcomes of mastectomy or lumpectomy. These patients suffer more post-operative adverse events. However, KTR experience superior outcomes at TCs.