Meister Phil, Vestweber Samira, Neuhaus Jan, Reschke Marc A, Neumann Ulf, Rink Andreas D
Department of General, Visceral, Vascular and Transplantation Surgery, University Hospital Essen, Essen, Germany.
Colorectal Dis. 2025 Jun;27(6):e70133. doi: 10.1111/codi.70133.
The incidence of colorectal carcinoma (CRC) in transplant (TX) recipients is higher than in the general population. Registry data indicate inferior oncological outcomes for this population. While the general surgical risk is increased in TX recipients, the risk associated with elective CRC surgery in this population is not well investigated.
TX recipients, who underwent elective surgical treatment for CRC at our specialized centre from 2008 to 2024 were included in this case-control study. The controls were randomly selected from our CRC database and matched according to tumour location and Charlson Comorbidity Index. Outcomes assessed included intensive care unit stay, in-hospital mortality, length of hospital stay and major morbidity (defined as Clavien-Dindo Grade ≥3).
The study included 24 TX recipients. Ten patients had had either liver or kidney TX, three patients had undergone lung TX and one patient heart TX. The mean time interval between transplantation surgery and CRC was 8.82 years. Morbidity was significantly higher in the TX group (54.2% vs. 8.3%, P = 0.001; OR 13.0, 95% CI 2.5-68,1, P = 0.002) and length of hospital stay was significantly longer (25 vs. 9 days, P = 0.001; OR 9.09, 95% CI 1.4-16.7, P = 0.022) for TX patients. No significant differences in mortality and intensive care unit stay were observed.
The risk of surgery for CRC in TX patients is significantly increased. Treatment decisions should involve TX experts to develop a tailored and considered treatment plan.
移植（TX）受者中结直肠癌（CRC）的发病率高于普通人群。登记数据显示该人群的肿瘤学结局较差。虽然TX受者的一般手术风险增加，但该人群中择期CRC手术相关风险尚未得到充分研究。
本病例对照研究纳入了2008年至2024年在我们的专科中心接受择期CRC手术治疗的TX受者。对照组从我们的CRC数据库中随机选取，并根据肿瘤位置和查尔森合并症指数进行匹配。评估的结局包括重症监护病房住院时间、院内死亡率、住院时间和严重并发症（定义为Clavien-Dindo分级≥3级）。
该研究纳入了24名TX受者。10例患者接受了肝脏或肾脏移植，3例患者接受了肺移植，1例患者接受了心脏移植。移植手术与CRC之间的平均时间间隔为8.82年。TX组的并发症发生率显著更高（54.2%对8.3%，P = 0.001；OR 13.0，95%CI 2.5 - 68.1，P = 0.002），TX患者的住院时间显著更长（25天对9天，P = 0.001；OR 9.09，95%CI 1.4 - 16.7，P = 0.022）。未观察到死亡率和重症监护病房住院时间的显著差异。
TX患者进行CRC手术的风险显著增加。治疗决策应包括TX专家，以制定量身定制且经过深思熟虑的治疗方案。
