Berenguer M, Prieto M, Bustamante M, Carrasco D, López-Andújar R, Mir J, Berenguer J
Servicio de Medicina Digestiva, Hospital Universitario La Fe, Valencia.
Med Clin (Barc). 1998 Oct 24;111(13):481-4.
De novo malignancy developing after transplantation constitutes a well-known complication or organ transplantation, mainly described among renal recipients.
To determine the incidence of de novo internal malignancies (excluding therefore skin cancers and recurrent hepatocellular carcinoma) in a cohort of 183 patients undergoing liver transplantation (OLT) between 6/1/1991 and 12/1/1996 with a minimum follow-up of 12 months and under cyclosporine-azathioprine-prednisone.
The study comprised 183 patients (mean age: 53 [8] years, with 70% males) whose charts were reviewed retrospectively. Rejection, steroids treatment, methyl-prednisolone bolus and OKT3 use were compared in the cases and in the matched control group.
Seven malignancies were detected: 3 lung carcinomas, 1 larynx, 1 prostate, 1 colon and 1 ovarian. The mean age was 53 (8) years. The diagnosis of cancer was made at an average time of 24 (17) months (range, 10-54) post-OLT. Three patients died with a mean survival of 31 (16) months. OLT indication was mainly for viral liver disease (5/7). Although not statistically significant, immunosuppression data were higher among patients with cancer than in the matched group. Two additional patients developed post-transplantation lymphoproliferative diseases at 2 and 9 months, respectively.
We observed a wide variety of malignancies after OLT, but no associated factor was found, even though there was a trend to higher doses of immunosuppression in patients with cancers. The institution of preventive measures and surveillance programs may allow for early institution of therapy, improving therefore the survival.
移植后新发恶性肿瘤是器官移植中一种众所周知的并发症，主要在肾移植受者中有所描述。
确定1991年1月6日至1996年12月1日期间接受肝移植（OLT）的183例患者中，新发内脏恶性肿瘤（因此不包括皮肤癌和复发性肝细胞癌）的发生率，这些患者至少随访12个月，且接受环孢素 - 硫唑嘌呤 - 泼尼松治疗。
该研究包括183例患者（平均年龄：53 [8]岁，70%为男性），对其病历进行回顾性分析。比较病例组和匹配对照组的排斥反应、类固醇治疗、甲泼尼龙冲击治疗和OKT3的使用情况。
检测到7例恶性肿瘤：3例肺癌、1例喉癌、1例前列腺癌、1例结肠癌和1例卵巢癌。平均年龄为53（8）岁。癌症诊断平均在OLT后24（17）个月（范围，10 - 54个月）做出。3例患者死亡，平均生存期为31（16）个月。OLT的主要适应证是病毒性肝病（5/7）。尽管无统计学意义，但癌症患者的免疫抑制数据高于匹配组。另外2例患者分别在2个月和9个月时发生移植后淋巴细胞增殖性疾病。
我们观察到OLT后出现多种恶性肿瘤，但未发现相关因素，尽管癌症患者的免疫抑制剂量有升高趋势。采取预防措施和监测方案可能有助于早期进行治疗，从而提高生存率。
