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Pretransplant malignancy in candidates and posttransplant malignancy in recipients of cardiac transplantation

Oechslin, E. ; Kiowski, W. ; Schneider, J. ; Follath, F. ; Turina, M. ; Gallino, A.

In: Annals of Oncology, 1996, vol. 7, no. 10, p. 1059-1063

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    Title
    • Pretransplant malignancy in candidates and posttransplant malignancy in recipients of cardiac transplantation
    Author
    • Oechslin, E.. Department of Internal Medicine, University Hospital Zurich, Switzerland
    • Kiowski, W.. Department of Internal Medicine, University Hospital Zurich, Switzerland
    • Schneider, J.. Department of Internal Medicine, University Hospital Zurich, Switzerland
    • Follath, F.. Department of Internal Medicine, University Hospital Zurich, Switzerland
    • Turina, M.. Division of Cardiac Surgery, University Hospital Zurich, Switzerland
    • Gallino, A.. Department of Internal Medicine, University Hospital Zurich, Switzerland
    Document Type
    • Postprint
    OAI-PMH Identifier
    • oai:doc.rero.ch:302054
    Summary
    Background: Malignancy is generally considered a contraindication for cardiac transplantation, whereas secondary malignancy has been described under chronic immunosuppression. Patients and methods: We report here the frequency of malignancy encountered among the 495 patients evaluated at our cardiac transplant centre as well as the incidence and the course of post-transplant malignancy among 129 consecutive patients who underwent cardiac transplantation, with a subsequent minimum follow-up of 6 months. Results: A total of 10 out of 495 patients (2%) evaluated for heart transplantation presented with a history of previous malignancy: 3 of them underwent transplantation (2 survive, 1 died) whereas in the remaining 7 patients neoplasia was considered a contraindication for cardiac transplantation, and all 7 died (4 cardiac, 3 tumor-related deaths). Post-transplant malignancy was diagnosed in 10 of 129 patients (9%) 35 ± 15 months after transplantation (6 skin cancers, 1 lymphoproliferative disease, 3 solid tumors). No significant association was found between post-transplant malignancy and primary prophylaxis with antithymocyte globulin (ATG) or murine antihuman T-cell monoclonal antibodies (OKT3). Conclusions: These results confirm that pre-transplant malignancy is not an absolute contraindication for cardiac transplantation and that post-transplant follow-up must include careful monitoring of post-transplant malignancy