Penn I
Department of Surgery, University of Cincinnati Medical Center, Ohio.
Surg Clin North Am. 1994 Oct;74(5):1247-57.
Although cancer is a complication of transplantation, one must emphasize that the great majority of organ allograft recipients do not develop this problem. The risk of developing a de novo malignancy is generally not a contraindication to transplantation. Many patients who develop de novo malignancies have readily treatable in situ carcinomas of the cervix, low-grade skin tumors, and in situ carcinomas of the vulva and perineum. However, with the limited experience gained thus far, nonrenal allograft recipients appear to be more prone to develop potentially life-threatening tumors, mainly lymphomas. Their occurrence may be related to the more intense immunosuppressive therapy that the surgeon is forced to give to some patients compared with renal allograft recipients. In these patients efforts to preserve a rejecting kidney may be abandoned in favor of dialysis and cessation of immunosuppressive therapy. A second transplantation can be performed at a later date when the patient has recovered from the effects of heavy immunosuppression. When large numbers of nonrenal allograft recipients have been followed for prolonged periods, it is likely that the pattern of malignancies described in renal allograft recipients will be seen in them as well.
虽然癌症是移植的一种并发症，但必须强调的是，绝大多数器官移植受者不会出现这个问题。发生新发恶性肿瘤的风险通常不是移植的禁忌症。许多发生新发恶性肿瘤的患者患有易于治疗的原位宫颈癌、低级别皮肤肿瘤以及外阴和会阴原位癌。然而，根据目前有限的经验，非肾移植受者似乎更容易发生可能危及生命的肿瘤，主要是淋巴瘤。它们的发生可能与外科医生被迫给予一些患者比肾移植受者更强的免疫抑制治疗有关。在这些患者中，为保留一个正在发生排斥反应的肾脏所做的努力可能会被放弃，转而进行透析并停止免疫抑制治疗。当患者从重免疫抑制的影响中恢复后，可以在稍后进行第二次移植。当大量非肾移植受者被长期随访时，很可能在他们身上也会看到肾移植受者中所描述的恶性肿瘤模式。
