Scimago Lab
powered by Scopus
call: +1.631.629.4327
Mon-Fri 10 am - 2 pm EST


Medical Science Monitor Basic Research


eISSN: 2329-0358

Get your full text copy in PDF

Evaluation of Transplant Candidates with Pre-Existing Malignancies

Israel Penn

Ann Transplant 1997; 2(4): 14-17

ID: 497326

A retrospective study was done of the recurrence rates of 1297 preexisting tumors in renal transplant recipients. Of 1137 neoplasms that were treated prior to transplantation, the recurrence rate was 21%, and it was 33% in 99 cancers treated after transplantation. Fifty-four percent of recurrences in the pretransplant-treated group occurred among malignancies treated within 2 years of transplantation, 33% in those treated 2-5 years before transplantation, and 13% among those treated more than 5 years pretransplantation. Among the 31 neoplasms in the last group 52% of recurrences occurred within 2 years after transplantation. Among those cancers treated pretransplantation the highest recurrence rates occurred with breast carcinomas (23%), symptomatic renal carcinomas (27%), sarcomas (29%), bladder carcinomas (29%), non melanoma skin cancers (53%) and multiple myeloma (67%). In the tumors treated posttransplantation 39% of recurrences were from nonmelanoma skin cancers. The bulk of evidence suggests that immunosuppressive therapy facilitates . the growth of residual cancers. With some exceptions a minimum waiting period of 2 years between treatment of a neoplasm, with a favorable prognosis, and undertaking renal transplantation is desirable. A waiting period of approximately 5 years is desirable for lymphomas, most carcinomas of the breast, prostate or colon, or for large (> 5cm) symptomatic renal carcinomas. No waiting period is necessary for incidentally discovered renal carcinomas, in situ carcinomas, and possibly tiny focal neoplasms. As it is highly unlikely that most candidates for nonrenal transplantation can be kept alive for a two year waiting period nonrenal transplantation can be undertaken in patients who have been treated for major cancers, provided that the disease appears to have been adequately controlled, and that the stage of the malignancy does not have a poor prognosis.

Keywords: Transplantation

This paper has been published under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.
I agree