The effect of sirolimus on prostate-specific antigen (PSA) levels in male renal transplant recipients without prostate cancer

K. Chamie, P. M. Ghosh, T. M. Koppie, V. Romero, C. Troppmann, R. W. DeVere White

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

In kidney recipients, the immunosuppressant sirolimus has been associated with a decreased incidence of de novo posttransplant malignancies (including prostate cancer). But the effect of sirolimus on the prostate-specific antigen (PSA) blood level, an important prostate cancer screening tool, remains unknown. We studied male kidney recipients >50 years old (transplanted from January 1994 to December 2006) without clinical evidence for prostate cancer. Pre- and posttransplant PSA levels were analyzed for 97 recipients (n = 19 on sirolimus, n = 78 on tacrolimus [control group]). Pretransplant PSA was similar for sirolimus versus tacrolimus recipients (mean, 1.8 versus 1.7 ng/mL, p = 0.89), but posttransplant PSA was significantly lower for recipients on sirolimus (mean, 0.9 versus 1.9 ng/mL, respectively, p < 0.001). The mean difference between pretransplant and posttransplant PSA was -0.9 ng/mL (50.0%, p = 0.006) for the sirolimus group versus +0.2 ng/mL (+11.8%, p = 0.24) for the tacrolimus group. By multivariate analysis, only pretransplant PSA and immunosuppression with sirolimus independently impacted posttransplant PSA. Our data strongly suggest that sirolimus is associated with a significant PSA decrease in kidney recipients. Future studies must investigate the clinical implications of our findings for the use of PSA for prostate cancer screening in male kidney recipients on sirolimus.

Original languageEnglish (US)
Pages (from-to)2668-2673
Number of pages6
JournalAmerican Journal of Transplantation
Volume8
Issue number12
DOIs
StatePublished - Dec 1 2008

Keywords

  • Gender
  • Kidney transplantation
  • Posttransplant cancer
  • Posttransplant malignancies
  • Posttransplant monitoring
  • Prevention
  • Prostate cancer
  • Recipient age
  • Sirolimus
  • Tacrolimus
  • Tumor

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

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