Bladder cancer in patients after organ transplantation.
OBJECTIVE
Bladder cancer development in organ transplant recipients remains a complex problem to manage as it has been demonstrated that the clinical course seems worse than in the general population. Most of the reports on bladder cancer after organ transplantation were done for kidney transplantation. Both virally and nonvirally are involved in bladder tumor development. The immunosuppressed status of the transplant recipients renders the screening, the therapeutic management, and the post-treatment surveillance very difficult.


RESULTS
With the increase of organ transplantation, especially renal transplantation, graft survival, and age of donor and recipient, urological cancer, including bladder cancer, become a critical problem affecting the survival. The advent of the new immunosuppressed drugs, mTOR inhibitors, leads to the hope of improving both survivals of the graft and of the recipients.


CONCLUSIONS
The molecular pathway P13K/Akt/mTOR is frequently activated during human solid tumor development and progression. However, mTOR inhibitors are also used in order to avoid renal allograft rejection. The combination of both actions could significantly improve graft and organ recipient survival and could provide progresses in targeted therapy management of bladder cancer.
Wallerand
Hervé
H
Department of Urology, Centre Hospitalo-Universitaire Pellegrin-Tripode, France.
Ravaud
Alain
A
Ferrière
Jean-Marie
JM
D006085:Graft Survival / Q000187:drug effects; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D047908:Intracellular Signaling Peptides and Proteins / Q000037:antagonists & inhibitors / Q000378:metabolism; D016030:Kidney Transplantation / Q000009:adverse effects*; D017346:Protein Serine-Threonine Kinases / Q000037:antagonists & inhibitors / Q000378:metabolism; D015398:Signal Transduction / Q000187:drug effects; D058570:TOR Serine-Threonine Kinases; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000209:etiology* / Q000378:metabolism / Q000517:prevention & control / Q000628:therapy
D007166:Immunosuppressive Agents; D047908:Intracellular Signaling Peptides and Proteins; C546842:MTOR protein, human; D017346:Protein Serine-Threonine Kinases; D058570:TOR Serine-Threonine Kinases