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Pretransplant solid organ malignancy and organ transplant candidacy: A consensus expert opinion statement

期刊

AMERICAN JOURNAL OF TRANSPLANTATION
卷 21, 期 2, 页码 460-474

出版社

ELSEVIER SCIENCE INC
DOI: 10.1111/ajt.16318

关键词

cancer; malignancy; neoplasia; clinical research; practice; editorial; personal viewpoint; organ transplantation in general; patient safety; recipient selection

资金

  1. Sanofi

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This article discusses the evaluation of solid organ transplantation for patients with a history of malignancy, emphasizing the need to balance the benefits of transplantation and the risk of tumor recurrence. It also points out that previous guidelines do not fully consider current staging, disease biology, and advances in cancer treatments.
Patients undergoing evaluation for solid organ transplantation (SOT) often have a history of malignancy. Although the cancer has been treated in these patients, the benefits of transplantation need to be balanced against the risk of tumor recurrence, especially in the setting of immunosuppression. Prior guidelines of when to transplant patients with a prior treated malignancy do not take in to account current staging, disease biology, or advances in cancer treatments. To develop contemporary recommendations, the American Society of Transplantation held a consensus workshop to perform a comprehensive review of current literature regarding cancer therapies, cancer stage-specific prognosis, the kinetics of cancer recurrence, and the limited data on the effects of immunosuppression on cancer-specific outcomes. This document contains prognosis based on contemporary treatment and transplant recommendations for breast, colorectal, anal, urological, gynecological, and nonsmall cell lung cancers. This conference and consensus documents aim to provide recommendations to assist in the evaluation of patients for SOT given a history of a pretransplant malignancy.

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