Characteristics and outcomes of heart transplant recipients with a pretransplant history of malignancy
- Author(s)
- Jong-Chan Youn; Darae Kim; Kyung An Kim; Jin-Jin Kim; In-Cheol Kim; Hye Sun Lee; Jin-Oh Choi; Eun-Seok Jeon; Keith Nishihara; Evan P. Kransdorf; David H. Chang; Michelle M. Kittleson; Jignesh K. Patel; Danny Ramzy; Fardad Esmailian; Jon A. Kobashigawa
- Keimyung Author(s)
- Kim, In Cheol
- Department
- Dept. of Internal Medicine (내과학)
- Journal Title
- Am J Transplant
- Issued Date
- 2022
- Volume
- 22
- Issue
- 12
- Keyword
- heart transplant; posttransplant malignancy; pretransplant malignancy; prognosis; recurrence; survival
- Abstract
- We aimed to investigate the characteristics and outcomes of HTx recipients with a history of pretransplant malignancy (PTM). Among 1062 HTx recipients between 1997 and 2013, 73 (7.1%) patients had PTMs (77 cancer cases). We analyzed post-HTx outcome, recurrence of PTM, and development of de novo malignancies. Post-HTx outcome included overall survival, 10-year survival, 10-year freedom from cardiac allograft vasculopathy (CAV), non-fatal major adverse cardiac events (NF-MACE), any treated rejection (ATR), acute cellular rejection (ACR), and antibody-mediated rejection (AMR). Four most common PTMs were lymphoproliferative disorders (18.2%), prostate cancers (18.2%), non-melanoma skin cancers (18.2%), and breast cancers (13.0%). Median time from PTM and HTx was 9.0 years. During a median follow-up of 8.6 years after HTx, patients with PTM, compared to those without, showed significantly higher incidence of posttransplant malignancies (43.8% vs. 20.8%, p < .001) including 9.6% (n = 7) of PTM recurrences. However, patients with PTM, compared to those without, showed comparable overall survival, 10-year survival, 10-year freedom from CAV, NF-MACE, ATR, ACR, and AMR. Therefore, a history of PTM should not disqualify patients from HTx listing, while further research is necessary for early detection of posttransplant malignancies in these patients.
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