title: Proliferation signal inhibitors and post-transplant malignancies in heart transplantation: practical clinical management questions.
abstract: Although malignancy is a major threat to long-term survival of heart transplant (HT) recipients, clear strategies to manage immunosuppression in these patients are lacking. Several lines of evidences support the hypothesis of an anticancer effect of proliferation signal inhibitors (PSIs: mammalian target of rapamycin [mTOR] inhibitors) in HT recipients. This property may arise from PSI's ability to replace immunosuppressive therapies that promote cancer progression, such as calcineurin inhibitors or azathioprine, and/or through their direct biological actions in preventing tumor development and progression. Given the lack of randomized studies specifically exploring these issues in the transplant setting, a collaborative group reviewed current literature and personal clinical experience to reach a consensus aimed to provide practical guidance for the clinical conduct in HT recipients with malignancy, or at high risk of malignancy, with a special focus on advice relevant to potential role of PSIs.
authors: Les Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
authors: E
authors: E
authors: Epailly
authors: J
authors: J
authors: Albanell
authors: A
authors: A
authors: Andreassen
authors: C
authors: C
authors: Bara
authors: J M
authors: JM
authors: Campistol
authors: J F
authors: JF
authors: Delgado
authors: H
authors: H
authors: Eisen
authors: A E
authors: AE
authors: Fiane
authors: P
authors: P
authors: Mohacsi
authors: S
authors: S
authors: Schubert
authors: L
authors: L
authors: Sebbag
authors: F M
authors: FM
authors: Turazza
authors: H
authors: H
authors: Valantine
authors: A
authors: A
authors: Zuckermann
authors: L
authors: L
authors: Potena