Predictive Factors of De Novo Malignancies After Living-Donor Liver Transplantation: A Single-Center Experience.

Autor: Wahab MA; Department of Surgery, Gastrointestinal Surgery Center, College of Medicine, Mansoura University, Egypt., Abdel-Khalek EE; Department of Hepatology, College of Medicine, Mansoura University, Egypt., Elshoubary M; Department of Surgery, Gastrointestinal Surgery Center, College of Medicine, Mansoura University, Egypt., Yassen AM; Department of Anesthesia and Intensive Care, College of Medicine, Mansoura University, Egypt., Salah T; Department of Surgery, Gastrointestinal Surgery Center, College of Medicine, Mansoura University, Egypt., Sultan AM; Department of Surgery, Gastrointestinal Surgery Center, College of Medicine, Mansoura University, Egypt., Fathy O; Department of Surgery, Gastrointestinal Surgery Center, College of Medicine, Mansoura University, Egypt., Elmorshedi M; Department of Anesthesia and Intensive Care, College of Medicine, Mansoura University, Egypt., Shiha U; Diagnostic & Interventional Radiology Department, Gastrointestinal Surgery Center, College of Medicine, Mansoura University, Egypt., Elsadany M; Department of Hepatology, College of Medicine, Mansoura University, Egypt., Adly R; Department of Anesthesia and Intensive Care, College of Medicine, Mansoura University, Egypt., Samy M; Department of Anesthesia and Intensive Care, College of Medicine, Mansoura University, Egypt., Shehta A; Department of Surgery, Gastrointestinal Surgery Center, College of Medicine, Mansoura University, Egypt. Electronic address: ahmedshehta@mans.edu.eg.
Jazyk: angličtina
Zdroj: Transplantation proceedings [Transplant Proc] 2021 Mar; Vol. 53 (2), pp. 636-644. Date of Electronic Publication: 2021 Feb 03.
DOI: 10.1016/j.transproceed.2021.01.033
Abstrakt: Background: De novo malignancies are a major reason of long-term mortalities after liver transplantation. However, they usually receive minimal attention from most health care specialists. The current study aims to evaluate our experience of de novo malignancies after living-donor liver transplantation (LDLT).
Methods: We reviewed the data of patients who underwent LDLT at our center during the period between May 2004 and December 2018.
Results: During the study period, 640 patients underwent LDLT. After a mean follow-up period of 41.2 ± 25.8 months, 15 patients (2.3%) with de novo malignancies were diagnosed. The most common de novo malignancies were cutaneous cancers (40%), post-transplantation lymphoproliferative disorders (13.3%), colon cancers (13.3%), and breast cancers (13.3%). Acute cellular rejection (ACR) episodes occurred in 10 patients (66.7%). Mild ACR occurred in 8 patients (53.3%), and moderate ACR occurred in 2 patients (13.3%). All patients were managed with aggressive cancer treatment. The mean survival after therapy was 40.8 ± 26.4 months. The mean overall survival after LDLT was 83.9 ± 52.9 months. Twelve patients (80%) were still alive, and 3 mortalities (20%) occurred. The 1-, 5-, and 10-year overall survival rates after LDLT were 91.7%, 91.7%, and 61.1%, respectively. On multivariate regression analysis, smoking history, operation time, and development of ACR episodes were significant predictors of de novo malignancy development.
Conclusions: Liver transplant recipients are at high risk for the development of de novo malignancies. Early detection and aggressive management strategies are essential to improving the recipients' survival.
(Copyright © 2021. Published by Elsevier Inc.)
Databáze: MEDLINE
Externí odkaz: