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Ann Thorac Surg 1995;60:1559-1560
© 1995 The Society of Thoracic Surgeons


Editorial

Solid Tumors in Cardiac Allograft Recipients

Israel Penn, MD

Department of Surgery, University of Cincinnati Medical Center, and Cincinnati Veterans Affairs Medical Center, Cincinnati, Ohio

The first 20% of the full text of this article appears below.

Most information about tumors that arise de novo after transplantation is gleaned from studies of renal allograft recipients. Overall there is threefold to fourfold increased incidence of cancer compared with age-matched controls in the general population [1, 2]. Apart from skin cancers (mostly squamous cell carcinomas [SCCs]), which show fourfold to 21-fold increased incidence, frequently encountered neoplasms in the general population (carcinomas of the lung, breast, prostate, and colon and invasive uterine cervical carcinomas) show no increase, but a variety of mostly uncommon tumors are seen.

Epidemiologic studies show increases of 28-fold to 49-fold of non-Hodgkin's lymphomas, 29-fold of lip carcinomas, 400-fold to 500-fold of Kaposi's sarcoma (KS), 100-fold of vulvar and anal carcinomas, 20-fold to 38-fold of hepatocellular carcinomas, 14-fold to 16-fold of in situ uterine cervical carcinomas, and small increases in sarcomas (excluding KS) and renal carcinomas. Up until May 1995 a worldwide tumor database, the Cincinnati Transplant Tumor Registry (CTTR), had information on 8,191 organ allograft recipients in whom 8,724 types of de novo cancer developed. The great majority (6,821) were kidney allograft recipients, but there were also 830 cardiothoracic (CT) recipients (772 cardiac, 29 lung, and 29 combined heart-lung) who had a total of 859 tumors [2]. Marked differences in the pattern of malignancies were apparent when CT and renal recipients were compared. The most significant finding was a disproportionately high incidence of lymphomas in CT recipients, comprising 39% of all malignancies versus 12% in renal recipients. (A similar high incidence of lymphomas was also seen in recipients of other extrarenal organs, in whom they comprised 55% of malignancies.) The difference was even more marked in pediatric compared with adult cardiac allograft recipients: lymphomas comprised 84% of tumors in pediatric patients compared with 37% in adults. . . . [Full Text of this Article]


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Neoplastic disease after heart transplantation: single center experience
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[Abstract] [Full Text] [PDF]




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