Singh Akash, De Arka, Singh Virendra
Department of Hepatology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Transl Gastroenterol Hepatol. 2020 Apr 5;5:30. doi: 10.21037/tgh.2019.11.18. eCollection 2020.
Post-transplant malignancy is emerging as an important cause of mortality in patients with cirrhosis undergoing liver transplant (LT). However, establishing the exact relationship between the two needs further evaluation. It has been observed that approximately 30% deaths after 10 years of hepatic transplantation occur due to de novo malignancies. Various known risk factors include immunosuppression, age of patient, alcoholic liver disease (ALD) or primary sclerosing cholangitis, smoking, and oncogenic viral infections. There is scanty literature on the post-transplant malignancy risk in patients with alcoholic cirrhosis. The current evidence suggests a particularly increased risk of oropharyngeal and lung cancers in patients transplanted for ALD. Abstinence from alcohol, smoking and other tobacco-containing products along with optimization of immunosuppression are paramount for decreasing the risk of post-transplant malignancies.
移植后恶性肿瘤正逐渐成为接受肝移植（LT）的肝硬化患者死亡的重要原因。然而，确定两者之间的确切关系需要进一步评估。据观察，肝移植10年后约30%的死亡是由新发恶性肿瘤所致。各种已知的风险因素包括免疫抑制、患者年龄、酒精性肝病（ALD）或原发性硬化性胆管炎、吸烟和致癌病毒感染。关于酒精性肝硬化患者移植后发生恶性肿瘤的风险，相关文献较少。目前的证据表明，因ALD接受移植的患者发生口咽癌和肺癌的风险尤其增加。戒酒、戒烟和其他含烟草产品，同时优化免疫抑制，对于降低移植后恶性肿瘤的风险至关重要。
