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Annals of Oncology 7:1059-1063, 1996
© 1996 European Society for Medical Oncology

research-article

Pretransplant malignancy in candidates and posttransplant malignancy in recipients of cardiac transplantation

E. Oechslin1,, W. Kiowski1, J. Schneider1, F. Follath1, M. Turina3 and A. Gallino1

1Department of Internal Medicine, University Hospital Zurich, Switzerland
2Institute of Pathology, University Hospital Zurich, Switzerland
3Division of Cardiac Surgery, University Hospital Zurich, Switzerland

Correspondence to: Augusto Gallino, MD Ospedale San giovanni 6500 bellinzona Switzerland

BACKGROUND:: Malignancy is generally considered a contraindication for cardiac transplantation, whereas secondary malignancy has been described under chronic immunosuppression.

PATIENTS AND METHODS:: We report here the frequency of malignancy encountered among the 495 patients evaluated at our cardiac transplant centre as well as the incidence and the course of post-transplant malignancy among 129 consecutive patients who underwent cardiac transplantation, with a subsequent minimum follow-up of 6 months.

RESULTS:: A total of 10 out of 495 patients (2%) evaluated for heart transplantation presented with a history of previous malignancy: 3 of them underwent transplantation (2 survive, 1 died) whereas in the remaining 7 patients neoplasia was considered a contraindication for cardiac transplantation, and all 7 died (4 cardiac, 3 tumor-related deaths). Post-transplant malignancy was diagnosed in 10 of 129 patients (9%) 35 ± 15 months after transplantation (6 skin cancers, 1 lymphoproliferative disease, 3 solid tumors). No significant association was found between post-transplant malignancy and primary prophylaxis with antithymocyte globulin (ATG) or murine antihuman T-cell monoclonal antibodies (OKT3).

CONCLUSIONS:: These results confirm that pre-transplant malignancy is not an absolute contraindication for cardiac transplantation and that post-transplant follow-up must include careful monitoring of post-transplant malignancy.

heart transplantation, malignancy


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