Section of Pediatric Nephrology and Hypertension, Department of Pediatrics, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Section of Infectious Diseases, Department of Medicine, Indiana University Health University Hospital, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Pediatr Transplant. 2022 Nov;26(7):e14341. doi: 10.1111/petr.14341. Epub 2022 Jul 9.
Malignancies are among the top three causes of patient death in pediatric and adult kidney transplant (KT) recipients. Solid organ transplant (SOT) recipients, including KT individuals, experience more cancer compared with the general population, including human papillomavirus (HPV)-related anogenital and oropharyngeal cancers. This article describes the epidemiology, pathophysiology and natural history of the HPV infection in both the general population and in SOT recipients, as well as its role in the development of HPV-related pre-cancerous lesions and cancers. Emphasis is given to the primary prevention strategy, HPV vaccination in SOT recipients, and its particularities compared with the general population. Secondary prevention strategies in SOT recipients are discussed and compared with the general population, highlighting cervical cancer screening needs within SOT populations. The article emphasizes how these primary and secondary HPV prevention strategies applied during childhood and adolescence by the pediatric transplant professionals, can lower the burden of HPV-related cancers for SOT recipients in subsequent years, during their adult life.
恶性肿瘤是儿科和成人肾移植 (KT) 受者死亡的三大原因之一。与普通人群相比，包括肾移植受者在内的实体器官移植 (SOT) 受者患癌症的风险更高，包括与人类乳头瘤病毒 (HPV) 相关的肛门生殖器和口咽癌症。本文描述了 HPV 在普通人群和 SOT 受者中的流行病学、病理生理学和自然史，以及其在 HPV 相关癌前病变和癌症发展中的作用。重点介绍了 SOT 受者的 HPV 疫苗接种的一级预防策略，以及与普通人群相比的特殊性。还讨论了 SOT 受者的二级预防策略，并与普通人群进行了比较，强调了 SOT 人群中宫颈癌筛查的需求。本文强调了儿科移植专业人员在儿童和青少年时期实施的这些 HPV 一级和二级预防策略，如何在随后的成年生活中降低 SOT 受者 HPV 相关癌症的负担。
