title: De novo cancers and post-transplant lymphoproliferative disorder in adult liver transplantation.
abstract: De novo cancer is one of the most serious complications after organ transplantation. Chronic immunosuppression, viral agents, pretransplant chronic alcohol-induced and other addictive behavior-induced injury are important conditions associated with the development of de novo cancers in solid organ transplants. The aim of the study was to evaluate types and clinical course of de novo cancers in adult liver transplant recipients. Data regarding 502 adult patients who underwent to 554 liver transplantations have been collected. Sex, age at transplantation, immunosuppressive regimen, time from transplantation to diagnosis of cancer, cancer type, surgical and non-surgical treatments and follow-up time have been analyzed as well as acute rejection episodes and viral status. Thirty patients developed 31 de novo cancers. The predominant tumors were carcinoma of the skin, lymphomas and Kaposi's sarcoma. Kaposi's sarcoma and lung cancer were associated with greater mortality. In lymphomas and Kaposi's sarcoma, a high rate of graft involvement was observed. In liver transplant recipients, de novo cancers demand strategies focusing on prophylactic and careful long-term screening protocols. Lymphomas and Kaposi's sarcoma should be ruled out in all patients with clinical manifestations of chronic biliary obstruction.
authors.affiliation: Department of General Surgery and Abdominal Organ Transplantation, Niguarda Hospital, Milan, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Aseni
authors.forename: Maurizio
authors.initials: M
authors.lastname: Vertemati
authors.forename: Luciano
authors.initials: L
authors.lastname: De Carlis
authors.forename: Cosimo Vincenzo
authors.initials: CV
authors.lastname: Sansalone
authors.forename: Edgardo
authors.initials: E
authors.lastname: Bonacina
authors.forename: Ernesto
authors.initials: E
authors.lastname: Minola
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Oreste
authors.forename: Laura
authors.initials: L
authors.lastname: Vizzotto
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Rondinara
mesh_terms: D000293:Adolescent; D000328:Adult; D002277:Carcinoma / Q000276:immunology / Q000473:pathology; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects; D007558:Italy / Q000453:epidemiology; D016031:Liver Transplantation / Q000009:adverse effects* / Q000276:immunology; D008223:Lymphoma / Q000276:immunology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000276:immunology / Q000401:mortality / Q000473:pathology*; D011183:Postoperative Complications / Q000276:immunology / Q000401:mortality / Q000473:pathology*; D012514:Sarcoma, Kaposi / Q000276:immunology / Q000473:pathology; D012878:Skin Neoplasms / Q000276:immunology / Q000473:pathology; D015996:Survival Rate
chemical_list: D007166:Immunosuppressive Agents