More than 10 percent of heart transplant recipients developed cancer between one and five years post-transplantation—most commonly skin cancer—according to a study published in the Journal of the American College of Cardiology.
Survival in transplant patients with de novo malignancy—the first occurrence of cancer in the body—is markedly shorter than those with no malignancy, reported lead author Jong-Chan Youn, MD, PhD, and colleagues.
“Importantly, the increased risk of mortality was sizeable even for patients diagnosed with skin cancer; this finding is in contrast to the general population, in whom survival after skin cancer is typically favorable,” Youn et al. wrote.
People undergoing organ transplants typically have their immune systems suppressed to help the new organ survive. But immunosuppression has direct carcinogenic effects, and no current guidelines exist to adjust it in different at-risk populations, the authors noted.
“Considering the increased burden of de novo malignancy in cardiac transplant recipients, additional effort needs to be directed toward formulating evidence-based cancer screening recommendations and optimized immunosuppression protocols for these patients,” Youn and colleagues wrote. “Relevant stakeholders, including oncologists, primary care physicians, and public health experts, as well as transplant cardiologists and immunologists, might be involved in the formulation of screening recommendations. In addition, it may be reasonable to consider the risk of de novo post-transplant malignancy in older patients when making decisions regarding candidacy for heart transplant versus left ventricular assist device as destination therapy.”Share