Lateef Noman, Abdul Basit Kalid, Abbasi Nadeem, Kazmi Syed Murtaza Hasan, Ansari Abdul Basit, Shah Mudassir
From the Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan.
Exp Clin Transplant. 2016 Feb;14(1):12-6. doi: 10.6002/ect.2015.0214. Epub 2015 Dec 1.
Along with graft vasculopathy, malignancies comprise a major complication after heart transplant, with a rate of occurrence of 39.1% in 10 years. Skin cancers and posttransplant lymphoproliferative disorder are more common in adults, whereas lymphoma is more often shown in children. A major cause of malignancies after heart transplant is the use of increased doses of prophylactics needed during immunosuppressive therapy. Data, however, are scarce regarding the association between a particular immunosuppressive drug and a posttransplant malignancy. Compared with the general population, recipients have a higher incidence of malignancies after heart transplant, with an early onset and more aggressive disease. Solid tumors known to occur in heart transplant recipients include lung cancer, bladder and prostate carcinoma, adenocarcinoma of the oral cavity, stomach cancer, and bowel cancer, although the incidence is rare. The risk factors for development of a malignancy after heart transplant are the same as for the nontransplant population.
除移植血管病变外,恶性肿瘤是心脏移植后的主要并发症,10年发生率为39.1%。皮肤癌和移植后淋巴细胞增殖性疾病在成人中更为常见,而淋巴瘤在儿童中更为常见。心脏移植后发生恶性肿瘤的一个主要原因是免疫抑制治疗期间需要增加预防性用药剂量。然而,关于特定免疫抑制药物与移植后恶性肿瘤之间的关联的数据很少。与普通人群相比,心脏移植受者移植后恶性肿瘤的发生率更高,发病更早且疾病更具侵袭性。已知心脏移植受者中发生的实体瘤包括肺癌、膀胱癌和前列腺癌、口腔腺癌、胃癌和肠癌,尽管发病率很低。心脏移植后发生恶性肿瘤的危险因素与非移植人群相同。