Sesa Vibor, Silovski Hrvoje, Basic-Jukic Nikolina, Kosuta Iva, Sremac Maja, Mrzljak Anna
Department of Gastroenterology and Hepatology, University Hospital Center Zagreb, Zagreb 10000, Croatia.
Department of Hepatobiliary Surgery and Transplantation, University Hospital Center Zagreb, Zagreb 10000, Croatia.
World J Transplant. 2024 Sep 18;14(3):95987. doi: 10.5500/wjt.v14.i3.95987.
Liver transplantation is as a crucial therapeutic option for patients with end-stage liver disease, but the persistent organ shortage emphasizes a need to explore unconventional donor sources, including individuals with a history of malignancies. This review investigates the viability of liver donation from individuals with current or past genitourinary malignancies, focusing on renal, prostate and urinary bladder cancers. The rising incidence of urogenital malignancies among potential donors is thought to result from increasing donor age. Analysis of transmission risks reveals low rates of donor-derived cancer transmission, particularly for early-stage renal and prostate cancers. Recipients with a history of genitourinary malignancy pose complex challenges regarding post-transplant immunosuppression and cancer recurrence. Nonetheless, the evidence suggests acceptable outcomes can be achieved with careful patient selection and tailored management strategies. Recommendations for pre-transplant evaluation and post-transplant surveillance are discussed, highlighting the need for individualized approaches in this patient population. Further prospective studies are warranted to refine guidelines and optimize outcomes in liver transplantation for patients with genitourinary malignancies.
肝移植是终末期肝病患者至关重要的治疗选择，但器官持续短缺凸显了探索非常规供体来源的必要性，包括有恶性肿瘤病史的个体。本综述探讨了目前或既往患有泌尿生殖系统恶性肿瘤的个体进行肝脏捐赠的可行性，重点关注肾癌、前列腺癌和膀胱癌。潜在供体中泌尿生殖系统恶性肿瘤发病率的上升被认为是供体年龄增加所致。对传播风险的分析显示，供体来源的癌症传播率较低，尤其是早期肾癌和前列腺癌。有泌尿生殖系统恶性肿瘤病史的受者在移植后免疫抑制和癌症复发方面面临复杂挑战。尽管如此，证据表明，通过仔细的患者选择和量身定制的管理策略，可以取得可接受的结果。讨论了移植前评估和移植后监测的建议，强调了针对该患者群体采取个体化方法的必要性。有必要进行进一步的前瞻性研究，以完善指南并优化泌尿生殖系统恶性肿瘤患者肝移植的结果。
