Malignancies: pre and post transplantation strategies
Meteb AlBugami1, Bryce Kiberd2
1Multiorgan Transplant Center, King Fahad Specialist Hospital, Dammam, Saudi Arabia.
Transplantation Reviews (Orlando, Fla.)
|January 21, 2014
Summary
Solid organ transplant recipients face a 2-3 fold higher cancer risk, particularly those linked to viral infections, suggesting immunosuppression plays a key role. This review examines cancer incidence and screening strategies in transplant patients.
Area of Science:
- Oncology
- Transplant Medicine
- Immunology
Background:
- Solid organ transplant recipients exhibit a 2-3 fold increased overall cancer incidence compared to the general population.
- Cancer risk patterns in transplant recipients resemble those in patients with acquired immunodeficiency syndrome, with many increased cancers associated with viral infections.
- Differences in cancer risk among specific organ transplant groups warrant further investigation, alongside the potential roles of organ damage and carcinogen exposure in advanced organ failure.
Purpose of the Study:
- To review cancer incidence and mortality in solid organ transplantation.
- To examine the role of pre-transplant screening and post-transplant surveillance in reducing cancer burden and improving patient outcomes.
- To focus on common cancers with high case fatality rates and potential screening strategies.
Main Methods:
- Literature review of cancer incidence and mortality in solid organ transplantation.
- Analysis of risk factors including immunosuppression and viral associations.
- Evaluation of pre-transplant screening and post-transplant surveillance strategies.
Main Results:
- Cancer risk is significantly elevated in transplant recipients, with variations across different malignancies, age groups, and geographic regions.
- Immunosuppression is a major contributing factor to increased cancer risk, evidenced by similarities to acquired immunodeficiency syndrome-associated malignancies.
- Advanced organ failure also confers increased risk for certain cancers, suggesting potential roles for organ damage or shared carcinogen exposures.
Conclusions:
- Immunosuppression is a primary driver of increased cancer risk post-solid organ transplantation.
- Targeted screening and surveillance strategies are crucial for managing cancer burden in transplant recipients.
- Further research is needed to understand organ-specific differences and the impact of organ damage on cancer development.
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