Cancer in Organ Recipients With Metastatic Spread to Transplant Organs: A Systematic Review

Area of Science:

• Transplant oncology
• Graft metastasis research
• Systematic review methodology

Background:

• Metastatic spread to transplanted organs is an infrequent complication.
• Increasing numbers of transplant recipients and improved long-term survival may lead to more reported cases.
• No prior systematic review has comprehensively analyzed graft metastases.

Purpose of the Study:

• To systematically review and synthesize all existing case studies of metastatic cancer in transplanted organs.
• To identify patterns in patient characteristics, primary tumors, transplant history, and outcomes.
• To establish a foundation for future research and standardized reporting of graft metastases.

Main Methods:

• Systematic literature search of EMBASE and PubMed databases adhering to PRISMA guidelines.
• Inclusion criteria focused on studies describing recipient cancer metastasizing to a transplant organ.
• Data extraction and summarization across patient demographics, tumor types, transplant details, imaging, treatment, and outcomes.

Main Results:

• Twelve studies met inclusion criteria, involving a mean patient age of 58 years.
• The liver (n=7) and kidney (n=4) were the most frequently affected transplanted organs.
• Colorectal cancer was the most common primary malignancy, with chemotherapy (5-fluorouracil, oxaliplatin, folinic acid) being the frequent treatment.

Conclusions:

• Metastatic spread to transplanted organs is exceptionally rare or significantly under-reported.
• Further investigation is crucial to elucidate the mechanisms of metastatic spread to grafts.
• Standardized reporting and targeted screening protocols for transplant recipients are recommended.