De novo malignancies following liver transplantation：report of 9 cases
10.3877/cma.j.issn.2095-3232.2014.03.005
- VernacularTitle:肝移植术后新发恶性肿瘤的发生和防治（附九例报告）
- Author:
Shuhong YI
1
;
Huimin YI
;
Binsheng FU
;
Bin NIU
;
Wei MENG
;
Hua LI
;
Chi XU
;
Yang YANG
;
Guihua CHEN
Author Information
1. 中山大学附属第三医院肝脏外科 肝移植中心
- Keywords:
Liver transplantation;
Postoperative complications;
Neoplasms,second primary;
Risk factors;
Smoking;
Immunosuppressive agents
- From:
Chinese Journal of Hepatic Surgery（Electronic Edition）
2014;(3):148-151
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the risk factors, prophylaxis and treatment of de novo malignancies following liver transplantation (LT). Methods Clinical data of 9 patients with de novo malignancies out of 416 patients who underwent LT and received complete follow-up in Liver Transplantation Center, the Third Affiliated Hospital of Sun Yat-sen University from October 2003 to December 2008 were analyzed retrospectively. Seven patients were male and 2 were female. The age ranged from 30 to 60 years old with a median of 57 years old. Four cases had smoking history before operation, 3 cases had long-term passive smoke exposure, and 1 case had family history of hepatocellular carcinoma. The informed consents of all patients were obtained and the ethical committee approval was received. Allogeneic modified piggyback LT was performed in all the patients. The immunosuppressive regimen was methylprednisolone + tacrolimus (FK506) or cyclosporine A (CsA). The patients were followed up after operation and the incidence, treatments and prognosis of malignancies were observed. Results The incidence of malignancies following LT was 2.2% (9/416) including digestive system malignancies (n=3), respiratory system malignancies (n=3), hematological malignancies (n=2) and soft tissue sarcoma (n=1). The elapsed time from LT to diagnosis was 10 to 73 months (median:49 months). The patients received surgery, radiotherapy, chemotherapy accordingly. After the operation, the immunosuppressant of 5 patients changed to sirolimus and 4 patients continued to take FK506 half the dose before tumor diagnosis. Six cases died of tumor progress and multiple organ failure during the follow-up. The interval time from diagnosis of tumor to death ranged from 2 to 25 months (median: 9 months). Conclusions Smoking and use of immunosuppressant may be high risk factors of malignancy following liver transplantation. Normative follow-up and prophylaxis and treatment at the earlier stage are the keys to improve the therapeutic effect.
