Department of Surgery, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
Eur J Cardiothorac Surg. 2010 May;37(5):1117-21. doi: 10.1016/j.ejcts.2009.11.028. Epub 2009 Dec 31.
Malignancy is the leading cause of death among heart-transplant recipients. There is a higher incidence of post-transplant malignancy in heart-transplant recipients than in kidney-transplant recipients. This study sought to assess the incidence of malignancy in heart-transplant recipients in Taiwan.
This is a retrospective chart review.
From 1987 to 2008, 291 patients who underwent heart transplantation and survived for more than 1 month were enrolled. Seventeen patients (5.8%) developed de novo malignancies including skin cancers (three), post-transplant lymphoproliferative diseases (seven) and solid-organ malignancies (seven). Solid-organ malignancies affected prostate, liver, urinary bladder, kidney, lung, larynx, pancreas and brain in seven patients. Malignancy was responsible for 7% and 13% of all death for heart-transplant recipients who lived for more than 1 year and more than 5 years. The cumulative incidence of 1.03% at 1 year, 4.2% at 5 years and 8.1% at 10 years in our patients was much lower than the incidences reported in the multicentre registry of the International Society for the Heart and Lung Transplantation and in the Western series. The incidence was especially low for skin cancers. Compared with previous reports of kidney-transplant recipients in Taiwan, the incidence of post-transplant malignancy was not significantly increased.
The incidence of post-transplant malignancy was low in Chinese heart-transplant recipients compared with heart-transplant recipients in Western countries. It resulted from a relative rarity of skin cancers in the Chinese population.
恶性肿瘤是心脏移植受者的主要死亡原因。心脏移植受者的移植后恶性肿瘤发病率高于肾移植受者。本研究旨在评估台湾地区心脏移植受者恶性肿瘤的发病率。
这是一项回顾性图表审查。
1987 年至 2008 年间，共纳入 291 例心脏移植后存活 1 个月以上的患者。17 例（5.8%）患者新发恶性肿瘤，包括皮肤癌（3 例）、移植后淋巴组织增生性疾病（7 例）和实体器官恶性肿瘤（7 例）。7 例实体器官恶性肿瘤分别影响前列腺、肝脏、膀胱、肾脏、肺、喉、胰腺和大脑。恶性肿瘤导致 7%和 13%的 1 年和 5 年以上存活的心脏移植受者死亡。我们的患者 1 年、5 年和 10 年的累积发病率分别为 1.03%、4.2%和 8.1%，远低于国际心肺移植学会多中心登记处和西方系列报告的发病率。皮肤癌的发病率尤其低。与台湾以前肾移植受者的报告相比，移植后恶性肿瘤的发病率没有显著增加。
与西方国家的心脏移植受者相比，中国心脏移植受者的移植后恶性肿瘤发病率较低。这是由于中国人种皮肤癌相对少见。
