Cancer After Heart Transplantation: A 25-year Single-center Perspective

Transplant Proc. 2016 Jul-Aug;48(6):2172-7. doi: 10.1016/j.transproceed.2016.03.037.

Abstract

Background: Cancer is a major cause of morbidity and mortality after heart transplantation.

Methods: We studied 541 heart transplant patients from a single center over a period of 25 years, with a mean follow-up of 10.7 years. We determined incidence, type, risk factors, and prognosis for cancer after heart transplantation.

Results: Cancer was diagnosed in 181 patients, at a mean of 7.7 years after transplantation. Cumulative incidence of cancer at 5, 10, and 20 years was 14%, 29%, and 60%, respectively. The most frequent cancers were spinocellular skin cancer (22%), basocellular skin cancer (19%), lung cancer (16%), lymphoma (11%) and prostate cancer (10%). Age at transplantation > 50 years (hazard ratio, 2.9; P < .001) and male recipient gender (hazard ratio, 1.7; P = .038) were significant risk factors for posttransplant malignancy on multivariate Cox proportional hazards analysis. Median patient survival after diagnosis of cancer was 2.9 years for patients with noncutaneous cancer, versus 13.1 years for patients with only skin cancer (P < .001).

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Female
  • Follow-Up Studies
  • Heart Transplantation / adverse effects*
  • Humans
  • Incidence
  • Lung Neoplasms / epidemiology
  • Lung Neoplasms / etiology
  • Lymphoma / epidemiology
  • Lymphoma / etiology
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasms / epidemiology
  • Neoplasms / etiology*
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology*
  • Proportional Hazards Models
  • Prostatic Neoplasms / epidemiology
  • Prostatic Neoplasms / etiology
  • Retrospective Studies
  • Risk Factors
  • Sex Factors
  • Skin Neoplasms / epidemiology
  • Skin Neoplasms / etiology
  • Time Factors