Scientific publications

Cancer incidence in heart transplant recipients with previous neoplasia history

Delgado JF (1), Alonso-Pulpón L (2), Mirabet S (3), Almenar L (4), Pérez Villa F (5), González-Vílchez F (6), Palomo J (7), Blasco T (8), García-Cosio MD (1), González-Costello J (9), de la Fuente L (10), Rábago G (11), Lage E (12), Pascual D (13), Díaz Molina B (14), Arizón JM (15), Muñiz J (16), Crespo-Leiro MG (17).
(1) Hospital Universitario 12 de Octubre, Madrid, Spain.
(2) Hospital Universitario Puerta de Hierro, Madrid, Spain.
(3) Hospital Santa Creu i Sant Pau, Barcelona, Spain.
(4) Hospital Universitari i Politècnic La Fe, Valencia, Spain.
(5) Hospital Clínic i Provincial, Barcelona, Spain.
(6) Hospital Universitario Marqués de Valdecilla, Santander, Spain.
(7) Hospital General Universitario Gregorio Marañón, Madrid, Spain.
(8) Hospital Universitario Miguel Servet, Zaragoza.
(9) Hospital Universitari de Bellvitge, Barcelona, Spain.
(10) Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
(11) Clínica Universidad de Navarra, Pamplona, Spain.
(12) Hospital Universitario Virgen del Rocío, Sevilla, Spain.
(13) Hospital Universitario Virgen de la Arrixaca, Murcia, Spain.
(14) Hospital Universitario Central de Asturias, Oviedo, Spain.
(15) Hospital Universitario Reina Sofía, Córdoba, Spain.
(16) Instituto Universitario de Ciencias de la Salud, Instituto de Investigación Biomédica de A Coruña (INIBIC), Universidade da Coruña, La Coruña.
(17) Hospital Universitario A Coruña, La Coruña.

Magazine: American Journal of Transplantation

Date: Nov 27, 2015

Cardiac Surgery [SP]


Neoplasm history increases morbidity and mortality after solid-organ transplantation and has disqualified patients from transplantation. Studies are needed to identify factors to be considered when deciding on the suitability of a patient with previous tumor for heart transplantation.

A retrospective epidemiological study was conducted in heart transplant (HT) recipients (Spanish Post-Heart-Transplant Tumor Registry) comparing the epidemiologic data, immunosuppressive treatments and incidence of post-HT tumors between patients with previous malignant non-cardiac tumors (PT) and with no previous tumors (NPT).

The impact of PT on overall survival (OS) was also assessed. 4,561 patients, 77 PT and 4,484 NPT, were evaluated. The NPT group had a higher proportion of men than the PT group (p<0.001). The incidence of post-HT tumors was 1.8 times greater in the PT group (95% CI=1.2-2.6; p<0.001), mainly due to the increased risk in patients with a previous hematologic tumor (RR=2.3; 95% CI=1.3-4.0, p<0.004).

OS during the 10-year post-transplant period was significantly lower in the PT than the NPT group (p=0.048) but similar when the analysis was conducted once a first post-HT tumor was diagnosed. In conclusion, a history of PT increases the incidence of post-HT tumors and should be taken into account when considering a patient for HT. 

CITATION  Am J Transplant. 2015 Nov 27. doi: 10.1111/ajt.13637.



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