The liver transplant recipients are two to three times more likely to develop DNM as compared to the general population. The increased risk of DNM is mainly due to the additive effect of risk factors unrelated to transplant, like smoking, tobacco consumption, geography, age, and transplant-related risk factors like chronic exposure to immunosuppression and etiology of liver disease (PSC/alcohol). Skin cancer is the most common DNM, followed by post-transplant lymphoproliferative disease. The DNM in liver transplant recipients is biologically more aggressive and associated with shorter survival as compared to similarly staged matched cancer in the general population. It is one of the leading causes of death in liver transplant recipients on long-term follow-up. Abstinence from alcohol consumption and smoking is related to decreased risk of DNM in liver transplant recipients. The guidelines for screening of DNM are based on general population guidelines for specific cancers. The management of DNM is like the general population. CNI minimization or withdrawal with either addition or conversion to mTOR inhibitors is recommended in all patients after the diagnosis of the solid DNM.

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De Novo Solid Organ Malignancy in Liver Transplant Recipients

  • Sanjay Kumar Yadav,
  • Sanjiv Saigal

摘要

The liver transplant recipients are two to three times more likely to develop DNM as compared to the general population. The increased risk of DNM is mainly due to the additive effect of risk factors unrelated to transplant, like smoking, tobacco consumption, geography, age, and transplant-related risk factors like chronic exposure to immunosuppression and etiology of liver disease (PSC/alcohol). Skin cancer is the most common DNM, followed by post-transplant lymphoproliferative disease. The DNM in liver transplant recipients is biologically more aggressive and associated with shorter survival as compared to similarly staged matched cancer in the general population. It is one of the leading causes of death in liver transplant recipients on long-term follow-up. Abstinence from alcohol consumption and smoking is related to decreased risk of DNM in liver transplant recipients. The guidelines for screening of DNM are based on general population guidelines for specific cancers. The management of DNM is like the general population. CNI minimization or withdrawal with either addition or conversion to mTOR inhibitors is recommended in all patients after the diagnosis of the solid DNM.