Department of Urology, Centre Hospitalo-Universitaire Pellegrin-Tripode, France.
Curr Opin Urol. 2010 Sep;20(5):432-6. doi: 10.1097/MOU.0b013e32833cf1ef.
Bladder cancer development in organ transplant recipients remains a complex problem to manage as it has been demonstrated that the clinical course seems worse than in the general population. Most of the reports on bladder cancer after organ transplantation were done for kidney transplantation. Both virally and nonvirally are involved in bladder tumor development. The immunosuppressed status of the transplant recipients renders the screening, the therapeutic management, and the post-treatment surveillance very difficult.
With the increase of organ transplantation, especially renal transplantation, graft survival, and age of donor and recipient, urological cancer, including bladder cancer, become a critical problem affecting the survival. The advent of the new immunosuppressed drugs, mTOR inhibitors, leads to the hope of improving both survivals of the graft and of the recipients.
The molecular pathway P13K/Akt/mTOR is frequently activated during human solid tumor development and progression. However, mTOR inhibitors are also used in order to avoid renal allograft rejection. The combination of both actions could significantly improve graft and organ recipient survival and could provide progresses in targeted therapy management of bladder cancer.
在器官移植受者中膀胱癌的发展仍然是一个难以处理的复杂问题，因为已经表明其临床病程似乎比普通人群更差。大多数关于器官移植后膀胱癌的报告都是针对肾移植的。病毒和非病毒都参与了膀胱癌的发展。移植受者的免疫抑制状态使得筛查、治疗管理和治疗后监测变得非常困难。
随着器官移植的增加，特别是肾移植、移植物存活率以及供体和受体的年龄的增加，包括膀胱癌在内的泌尿系统癌症成为影响生存的一个关键问题。新型免疫抑制剂 mTOR 抑制剂的出现，给移植物和受者的存活率的提高带来了希望。
P13K/Akt/mTOR 分子通路在人类实体肿瘤的发展和进展过程中经常被激活。然而，mTOR 抑制剂也被用于避免肾移植排斥。这两种作用的结合可以显著提高移植物和器官受者的存活率，并为膀胱癌的靶向治疗管理提供进展。
