Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
Transplant Proc. 2021 Jan-Feb;53(1):200-206. doi: 10.1016/j.transproceed.2020.02.148. Epub 2020 May 11.
Several studies have reported that solid organ transplant recipients have a high risk for malignant tumors because the suppressed immune system fails in preventing malignant transformations. De novo malignancy after transplantation is the most common cause of death in the late period after liver transplant (LT). This study investigated the clinical significance of de novo malignancy after LT, and it is the largest study based in Korea to report long-term follow-up results associated with de novo malignancy after LT.
Data of 1793 adults who underwent LT in Seoul National University Hospital were retrospectively collected, and medical charts and data from the Ministry of Public Administration and Security were reviewed to examine the causes of death and de novo malignancy status. The Fisher exact test and Kaplan-Meier survival analysis were used to analyze the data.
Of the 1793 recipients, 27 died of de novo malignancies. Of 875 hepatocellular carcinoma (HCC) patients, 12 died, and of 918 non-HCC patients, 15 died. De novo malignancy was the main cause of death at 5 years after LT but was not in the initial 5 years. In Korea the most common cancers that developed after LT were gastric cancer (21.4%) and lymphoma (14.3%). De novo HCC in non-HCC cases was found in 2 patients.
De novo malignancy is a key factor affecting long-term survival after LT. Therefore, regular screening and education are important for improving long-term survival and quality of life in these patients after LT.
多项研究表明，实体器官移植受者发生恶性肿瘤的风险较高，因为受抑制的免疫系统未能预防恶性转化。移植后新发恶性肿瘤是肝移植（LT）后晚期死亡的最常见原因。本研究探讨了 LT 后新发恶性肿瘤的临床意义，这是在韩国进行的最大规模研究，报告了与 LT 后新发恶性肿瘤相关的长期随访结果。
回顾性收集了在首尔国立大学医院接受 LT 的 1793 名成年人的数据，并查阅了卫生部和公共行政安全部的病历和数据，以检查死亡原因和新发恶性肿瘤状况。使用 Fisher 确切检验和 Kaplan-Meier 生存分析对数据进行分析。
在 1793 名受者中，有 27 人死于新发恶性肿瘤。在 875 例肝细胞癌（HCC）患者中，有 12 人死亡，在 918 例非 HCC 患者中，有 15 人死亡。新发恶性肿瘤是 LT 后 5 年死亡的主要原因，但不在最初的 5 年内。在韩国，LT 后最常见的癌症是胃癌（21.4%）和淋巴瘤（14.3%）。在非 HCC 病例中发现了 2 例新发 HCC。
新发恶性肿瘤是影响 LT 后长期生存的关键因素。因此，定期筛查和教育对于提高这些患者 LT 后的长期生存和生活质量非常重要。
