Introduction: The risk of developing cancer in organ transplant patients is higher than in the general population. Factors such as extended post-transplant survival and the use of immunosuppressive medications after transplantation contribute to an increased risk of cancer in these patients. This situation is an important health problem for transplant centers. In this study, we evaluated the frequency of cancer developing during the follow-up of patients transplanted in our center.
Method: In this single-center retrospective study, patients who underwent organ transplantation at Başkent University Faculty of Medicine Hospital between 2000 and 2023 were evaluated. Among these patients, patients who underwent kidney, liver and heart transplantation and who were older than 18 years of age were included in the study. Patients diagnosed with cancer during post-transplant follow-up were examined in detail. Between the specified dates, 1047 of 1271 kidney transplant recipients, 204 of 512 liver transplant recipients, and 70 of 117 heart transplant recipients met the inclusion criteria.
Results: We identified cancer development during post-transplant follow-up in 63 out of 1047 patients who kidney transplant patients, 16 out of 204 patients who liver transplant patients, and 3 out of 70 patients who heart transplant patients. A total of 82 out of 1321 transplant patients (6.2%) developed cancer. Among these patients, 63 patients (76.8%) had kidney transplantation, 16 patients (19.5%) had liver transplantation, and 3 patients (3.7%) had heart transplantation. 23 (28%) of the patients were transplanted from a cadaver and 59 (72%) of the patients were transplanted from a living donor. Of the patients, 62 were male (75.6%) and 20 (24.4%) were female. In the follow-up of a patient who kidney transplant patient, squamous cell carcinoma first developed and basal cell carcinoma developed approximately one year later. Among patients diagnosed with cancer, 33 (40.3%) developed basal and squamous cell skin cancers, 13 (15.9%) developed Posttransplant Lymphoproliferative Disorder (PTLD)/Lymphoma, 6 (7.3%) developed Kaposi's Sarcoma, and 6 (7.3%) developed Papillary Thyroid Carcinoma. 60 (73.2%) of the patients diagnosed with cancer were alive at the time of this study.
Conclusion: Post-transplant malignancy is a significant health issue. Fortunately, due to close monitoring of these patients, the majority are detected at early stages, leading to a favorable prognosis. Detection of the disease at an early stage enables treatment possible with surgical resection in most patients. Early diagnosis should be targeted in this patient group with a high risk of malignancy.