Incidence and Treatment of Cancer in Transplant Recipients

1998 ◽  
Vol 8 (2) ◽  
pp. 105-112 ◽  
Author(s):  
Maureen P. Flattery
Keyword(s):  
De Novo ◽  
Solid Organ Transplantation ◽  
Organ Transplant ◽  
Cardiac Transplant ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Organ Transplant Recipients ◽  
Organ Rejection ◽  
Increased Risk ◽  
Actuarial Risk

Solid organ transplantation has been an accepted mode of therapy for the treatment of end-stage organ diseases for many years. Recipients' survival, however, has been hindered by organ rejection and the comorbid diseases that develop as a result of immunosuppressive therapy. In particular, organ transplant recipients have an increased risk of developing cancer de novo after transplantation. Prevalence ranges from 4 to 18% with an average incidence of 6%. Data submitted to the Cincinnati transplant tumor registry have revealed that cancers prevalent in the general population exhibited no increase in rate and may even show a slight decline in the transplant population. Length of survival after transplantation is associated with the likelihood of having cancer; the longer the recipient survives, the greater the chance. The actuarial risk among 124 cardiac transplant recipients was 2.7+/-1.9% at 1 year and 25.6+/-11% at 5 years. This article will review the current literature on the incidence and treatment of cancer in solid organ transplant recipients.

scholarly journals Viral Enteritis in Solid-Organ Transplantation

Viruses ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 2019
Author(s):  
Anum Abbas ◽  
Andrea J. Zimmer ◽  
Diana Florescu
Keyword(s):  
Solid Organ Transplantation ◽  
Organ Transplant ◽  
Solid Organ Transplant ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Post Transplantation ◽  
Organ Transplant Recipients ◽  
Increased Risk ◽  
Viral Enteritis ◽  
Solid Organ Transplant Recipients

Solid organ transplant recipients are at increased risk for infections due to chronic immunosuppression. Diarrhea is a commonly encountered problem post transplantation, with infectious causes of diarrhea being a frequent complication. Viral infections/enteritides in solid organ transplant recipients often result from frequently encountered pathogens in this population such as cytomegalovirus, adenovirus, and norovirus. However, several emerging viral pathogens are increasingly being recognized as more sensitive diagnostic techniques become available. Treatment is often limited to supportive care and reduction in immunosuppression, though antiviral therapies mayplay a role in the treatment in certain diseases. Viral enteritis is an important entity that contributes to morbidity and mortality in transplant recipients.

scholarly journals The Role of Systems Vaccinology in Understanding the Immune Defects to Vaccination in Solid Organ Transplant Recipients

2020 ◽  
Vol 11 ◽  
Author(s):  
Nicholas Scanlon ◽  
Youssef Saklawi ◽  
Nadine Rouphael
Keyword(s):  
Systems Biology ◽  
Organ Transplant ◽  
Solid Organ Transplant ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Organ Transplant Recipients ◽  
Organ Rejection ◽  
Increased Risk ◽  
Solid Organ Transplant Recipients ◽  
Immune Defects

Solid organ transplant recipients (SOTRs) are at increased risk for many infections, whether viral, bacterial, or fungal, due to immunosuppressive therapy to prevent organ rejection. The same immune defects that render transplanted patients susceptible to infection dampen their immune response to vaccination. Therefore, it is vital to identify immune defects to vaccination in transplant recipients and methods to obviate them. These methods can include alternative vaccine composition, dosage, adjuvants, route of administration, timing, and re-vaccination strategies. Systems biology is a relatively new field of study, which utilizes high throughput means to better understand biological systems and predict outcomes. Systems biology approaches have been used to help obtain a global picture of immune responses to infections and vaccination (i.e. systems vaccinology), but little work has been done to use systems biology to improve vaccine efficacy in immunocompromised patients, particularly SOTRs, thus far. Systems vaccinology approaches may hold key insights to vaccination in this vulnerable population.

Skin Cancers and Lung Transplant

2021 ◽  
Vol 42 (03) ◽  
pp. 483-496
Author(s):  
Reason Wilken ◽  
John Carucci ◽  
Mary L. Stevenson
Keyword(s):  
Cell Carcinoma ◽  
Lung Transplant ◽  
Radiation Treatment ◽  
Organ Transplant ◽  
Adjuvant Radiation ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Organ Transplant Recipients ◽  
Skin Cancers ◽  
Increased Risk

AbstractIt is well known that solid-organ transplant recipients (SOTRs) have a 65- to 100-fold increase in the risk of developing skin cancer, namely, nonmelanoma skin cancers (NMSCs) such as cutaneous squamous cell carcinoma (cSCC) and basal cell carcinoma (BCC). In addition, these patients are also at increased risk for development of melanoma as well as other less common cutaneous malignancies (Merkel's cell carcinoma, Kaposi's sarcoma). SOTRs with NMSC (namely cSCC) are also at significantly increased risk of poor clinical outcomes including local recurrence, nodal and distant metastasis, and disease-specific death relative to patients who are not immunosuppressed. Increased surveillance and monitoring in patients at risk of aggressive disease and poor outcomes who are on immunosuppression is essential in patients with lung transplants given the high degree of immunosuppression. Increased awareness of risks, treatments, and management allows for improved outcomes in these patients. This article will provide an overview of the risk factors for the development of cutaneous malignancies in organ transplant recipients as well as a detailed discussion of various immunosuppressant and prophylactic medications used in this patient population that contribute to the risk of developing cutaneous malignancies, with an emphasis on NMSC (cSCC and BCC) in lung transplant recipients. Finally, this article includes a discussion on the clinical and dermatologic management of this high-risk immunosuppressed population including a review of topical and systemic agents for field therapy of actinic damage and chemoprevention of keratinocyte carcinomas. In addition, indications for additional treatment and preventive measures such as adjuvant radiation treatment after surgical management of cutaneous malignancies and potential modification of immunosuppressive medication regimens are discussed.

scholarly journals Challenges in the Diagnosis and Management of Bacterial Lung Infections in Solid Organ Recipients: A Narrative Review

2020 ◽  
Vol 21 (4) ◽  
pp. 1221 ◽  
Author(s):  
Manuela Carugati ◽  
Letizia Morlacchi ◽  
Anna Peri ◽  
Laura Alagna ◽  
Valeria Rossetti ◽  
...  
Keyword(s):  
Respiratory Infections ◽  
Solid Organ Transplantation ◽  
Organ Transplant ◽  
Solid Organ Transplant ◽  
Narrative Review ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Organ Transplant Recipients ◽  
Diagnosis And Management ◽  
Solid Organ Transplant Recipients

Respiratory infections pose a significant threat to the success of solid organ transplantation, and the diagnosis and management of these infections are challenging. The current narrative review addressed some of these challenges, based on evidence from the literature published in the last 20 years. Specifically, we focused our attention on (i) the obstacles to an etiologic diagnosis of respiratory infections among solid organ transplant recipients, (ii) the management of bacterial respiratory infections in an era characterized by increased antimicrobial resistance, and (iii) the development of antimicrobial stewardship programs dedicated to solid organ transplant recipients.

scholarly journals Scedosporiosis in a Combined Kidney and Liver Transplant Recipient: A Case Report of Possible Transmission from a Near-Drowning Donor

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Rachael Leek ◽  
Erika Aldag ◽  
Iram Nadeem ◽  
Vikraman Gunabushanam ◽  
Ajay Sahajpal ◽  
...  
Keyword(s):  
Solid Organ Transplantation ◽  
Organ Transplant ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Near Drowning ◽  
Saprobic Fungi ◽  
Increased Risk ◽  
Serious Infections ◽  
Solid Organ Transplant Recipients ◽  
Immunocompromised Hosts

Scedosporium spp. are saprobic fungi that cause serious infections in immunocompromised hosts and in near-drowning victims. Solid organ transplant recipients are at increased risk of scedosporiosis as they require aggressive immunosuppression to prevent allograft rejection. We present a case of disseminated Scedosporium apiospermum infection occurring in the recipient of a combined kidney and liver transplantation whose organs were donated by a near-drowning victim and review the literature of scedosporiosis in solid organ transplantation.

scholarly journals Increased Risk for Lymphoid and Myeloid Neoplasms in Elderly Solid-Organ Transplant Recipients

2010 ◽  
Vol 19 (5) ◽  
pp. 1229-1237 ◽  
Author(s):  
Scott C. Quinlan ◽  
Lindsay M. Morton ◽  
Ruth M. Pfeiffer ◽  
Lesley A. Anderson ◽  
Ola Landgren ◽  
...  
Keyword(s):  
Organ Transplant ◽  
Solid Organ Transplant ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Organ Transplant Recipients ◽  
Myeloid Neoplasms ◽  
Increased Risk ◽  
Solid Organ Transplant Recipients

De novo sarcomas in solid organ transplant recipients

2002 ◽  
Vol 34 (5) ◽  
pp. 1786-1787 ◽  
Author(s):  
T.L Husted ◽  
J.F Buell ◽  
M.J Hanaway ◽  
J Trofe ◽  
T Beebe ◽  
...  
Keyword(s):  
De Novo ◽  
Organ Transplant ◽  
Solid Organ Transplant ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Organ Transplant Recipients ◽  
Solid Organ Transplant Recipients

Photoprotection Knowledge and Behaviours Among Organ Transplant Recipients

2017 ◽  
Vol 21 (3) ◽  
pp. 217-220 ◽  
Author(s):  
Kirsten Walker ◽  
Kerry Gardner ◽  
Angela Law ◽  
Nicole Hawkins ◽  
Peter Hull
Keyword(s):  
Skin Cancer ◽  
De Novo ◽  
Organ Transplant ◽  
Malignant Neoplasm ◽  
Sun Exposure ◽  
Transplant Recipients ◽  
Cancer Awareness ◽  
Organ Transplant Recipients ◽  
Increased Risk ◽  
Sun Avoidance

Background: Organ transplant recipients (OTRs) are at an increased risk of developing a de novo malignant neoplasm compared to the general population. The primary contributor to skin cancer in all patients is sun exposure. Objective: In this study, we aim to ascertain both OTR skin cancer awareness and photoprotection practices. Methods: A questionnaire-based study of Saskatchewan transplant recipients. Results: Nearly all respondents were aware that sun exposure is the best-known cause of skin cancer and that as an OTR, they are at increased risk of skin cancer (99.3% and 90.5%, respectively). Approximately half of respondents reported wearing a hat regularly, sun avoidance between 10 am and 3 pm, or wearing sunscreen regularly (53.7%, 33.1%, and 47.9%, respectively). Conclusion: Many OTRs are not engaging in photoprotection. Further intervention, which may include access to a dermatologist, is necessary to ensure ORTs do not experience undue morbidity and mortality secondary to skin cancer.

scholarly journals New Blood Borne Virus Infections Among Organ Transplant Recipients: A Data-Linked Cohort Study Examining Transmissions and De Novo Infections

2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Karen MJ Waller ◽  
Nicole L De La Mata ◽  
James A Hedley ◽  
Brenda M Rosales ◽  
Michael J O’Leary ◽  
...  
Keyword(s):  
At Risk ◽  
Cohort Study ◽  
De Novo ◽  
Organ Transplant ◽  
Health Data ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Transmitted Infection ◽  
Organ Transplant Recipients ◽  
Administrative Health Data

IntroductionSolid organ transplant recipients are at risk of infections, which may be either derived through transplantation or acquired later. Blood-borne viruses (BBV) are a particular concern for donor-derived transmissions. There is an increasing emphasis on biovigilance – monitoring the safety of donated organs. However, systematic surveillance to distinguish donor-transmitted infection from de novo post-transplant infection is challenging. Additional information can be obtained through linkage of administrative health data. Objectives and ApproachWe aimed to identify donor-transmitted and de novo BBV infections among organ transplant recipients. We conducted a cohort study of all solid organ donor-recipient pairs in New South Wales, Australia, 2000-2015. Donor and recipient BBV infections were identified by linking transplant registries with administrative health data. Proven/probable donor-transmissions were identified among new recipient infections within 12 months of transplant, classified according to an international algorithm. All other new BBV infections were classified as de novo infections. ResultsAmong 2,120 organ donors, 73 had a BBV infection (11/73 active, 62/73 past). Donors with BBV donated to 176 recipients, of whom 24/176 had the same BBV as their donor, and 152/176 did not; these 152 recipients were at risk of donor-transmission. Among those at risk, there were 3/152 proven/probable BBV transmissions (1 hepatitis C, 2 hepatitis B [HBV]) and 149/152 recipients with non-transmissions. All donor-transmissions were previously recognised by donation services, and were from donors with known BBV. There were no deaths from transmissions. There were 70 recipients with de novo BBV; 2/70 died from new HBV. Conclusion / ImplicationsThis work confirms the safety of Australian organ donation, with no unrecognised BBV transmissions and many non-transmissions from donors with BBV. This may support increasing targeted donation from donors with BBV. However, de novo BBV infections were substantial and preventable. Data-linkage may be a useful adjunct to current biovigilance systems.

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