Morbidity and risk factors of de novo malignancy after heart transplantation
10.3760/cma.j.cn421203-20221023-00269
- VernacularTitle:心脏移植术后新发恶性肿瘤发病率及危险因素分析
- Author:
Lin ZHANG
1
;
Pengsainan SUN
;
Jie HUANG
;
Zhongkai LIAO
;
Sheng LIU
;
Yunhu SONG
;
Wei WANG
;
Zhe ZHENG
Author Information
1. 中国医学科学院阜外医院 国家心血管病中心 心脏移植中心心外科，北京 100037
- Keywords:
Heart transplantation;
Malignant tumor;
Incidence;
Risk factor
- From:
Chinese Journal of Organ Transplantation
2023;44(6):360-365
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the morbidity and risk factors of de novo malignancy after heart transplantation (HT).Methods:From June 2004 to August 2021, 995 patients undergoing HT were selected and followed up.The epidemiological characteristics, the morbidity of de novo malignancy (DNM) and its risk factors were examined.Kaplan-Meier survival analysis was performed for calculating the cumulative incidence and mortality of DNM.Log rank test was utilized for comparing the survival rate of each subgroup.Cox regression model was employed for examining the relationship between the included factors and the endpoint of DNM.Results:The median follow-up period was 6.36(3.64, 10.18) years.Thirty-six patients (3.6%) developed DNM during follow-up.Lung cancer accounted for 22.2%(8/36) of DNM while digestive system tumors accounted for 38.9% (including gastric cancer 6/36, 16.7%; liver cancer 3/36, 8.3%; colon cancer 2/36, 5.6%). The cumulative morbidity of DNM at Year 1/5/10/15 post-HT was 0.1%, 2.3%, 4.9% and 7.6% respectively.The median survival time of DNM recipients was 83.32 months.The mean survival time was significantly lower than those without DNM[(115.32±13.12) vs.(194.22±2.58), P<0.001]. The mortality of DNM recipients was around 6.57 folds higher ( HR=6.57, 95% CI: 4.06-10.64, P<0.01). Age was an independent risk factor for an occurrence of DNM.Hypertension and diabetes were also correlated with DNM. Conclusions:DNM after HT is associated with shorter survival time.And age is an independent risk factor for DNM after HT.
