Post-transplant cancers

The progress in transplantology and use of new immunosuppressants improved survival time of patients after transplantation. Malignancies are the main cause of death patients with functioning graft. Skin malignancies other than melanoma are the most frequent neoplasms in patients with kidney and liver transplantations. The highest incidence of malignancies after transplantation is related to potential oncogenic viral infection such as Kaposi's sarcoma caused by human herpes virus type 8, post-transplant lymphoproliferative disorder caused by Epstein-Barr virus and malignancies probably caused by human papilloma virus or hepatitis B/C virus. Risk of solid tumor incidence according to some investigators is 2-4 times higher than in general population. Lung cancer, gastrointestinal cancers and urinary tract tumors are observed in less than 1% of patients after liver transplantation. The most common malignancies in patients after heart transplantation are lymphomas, lung cancer, urinary tract malignancies and skin neoplasms. Age, high dose of immunosuppressants, life style and egzogenic cancerogenous factors exposure are the main risk factors in patients after organ transplantations. Risk of malignancy after transplantation is higher in case of use calcineurin inhibitors than other agents. Immunosuppressive treatment not only may determine type and frequency of malignancy, but also worsens prognosis independently of clinical stage of disease compared to general population. Use of new immunosuppressants with specific antineoplastic activity may reduce the incidence of the neoplasms after organ transplantation.