• Liver cancer
• Liver resection
• Liver transplantation
• Tumor microenvironment

• incidence
• liver transplantation
• risk factors
• screening
• skin cancer

• R306-A18169 Danish Cancer Society

• comprehensive complication index
• liver transplantation
• primary sclerosing cholangitis

• Humans
• End Stage Liver Disease/surgery
• Cholangitis, Sclerosing/complications
• Cholangitis, Sclerosing/surgery
• Liver Transplantation/adverse effects
• Severity of Illness Index
• Bile Ducts, Intrahepatic
• Bile Duct Neoplasms
• Morbidity
• Retrospective Studies

• liver transplantation
• lung cancer
• meta-analysis
• standardized incidence ratio

• Humans
• Liver Transplantation/adverse effects
• Incidence
• Risk Factors
• Lung Neoplasms/epidemiology
• Lung Neoplasms/etiology
• North America

• Cancer screening
• Female-specific cancer
• Solid organ transplant

• Liver transplantation
• de novo cancer
• immunosuppressive treatment

• Italy
• cohort study
• immunosuppression
• kidney transplant
• trend
• virus-related malignancy

• (AIRC IG No. 19112) Italian Association for Research on Cancer
• (Ricerca Corrente to IRCCS INMI L. Spallanzani, and Ricerca Corrente to IRCCS CRO Aviano) Italian Ministry of Health
• - Seed Grant to MT CRO Aviano "5x1000 (Redditi 2018)"

• Adult
• Child
• Cholangitis, Sclerosing/complications
• Cholangitis, Sclerosing/diagnosis
• Cholangitis, Sclerosing/therapy
• Humans
• Prognosis

Cancer is a significant cause of morbidity and mortality after solid organ transplantation (SOT) and related to lifelong immunosuppression. This retrospective registry study assessed for the first time in Finland population‐based cancer risk and cancer mortality after all SOTs (lung and childhood transplantations included) as standardized incidence ratios (SIRs) and standardized mortality ratios (SMRs). Data from transplant registries were linked with the data of Finnish Cancer Registry and Statistics Finland. We followed 6548 consecutive first SOT recipients from 1 January 1987 to 31 December 2016 translating to 66 741 person‐years (median follow‐up time 8.9 years [interquartile range 4.0‐15.1]). In total, 2096 cancers were found in 1483 patients (23% of all patients). Majority of cancers (53%) were nonmelanoma skin cancers (NMSCs). The overall SIR was 3.6 (95% confidence interval [CI]: 3.5‐3.8) and the SIR excluding NMSCs was 2.2 (95% CI: 2.0‐2.3). SIR for all cancers was highest for heart (5.0) and lowest for liver (2.7) recipients. Most common cancer types after NMSCs were non‐Hodgkin lymphoma (NHL), SIR 9.9 (95% CI: 8.5‐11.4) and kidney cancer, SIR 7.3 (95% CI: 6.0‐8.8). Cancer‐related deaths were 17% (n = 408) of all deaths after first month post transplantation. SMR for all cancers was 2.5 (95% CI: 2.2‐2.7) and for NHL 13.6 (95% CI: 10.7‐16.8). Notably, overall SIR for cancer was lower in later period (2000‐2016), 3.0 (95% CI: 2.8‐3.2), than in earlier period (1987‐1999), 4.3 (95% CI: 4.0‐4.5), P < .001. Decrease in cancer incidence was temporally associated with major changes in immunosuppression in the 2000s.

• cancer risk
• mortality
• population-based
• solid organ transplantation
• standardized incidence ratio

• Cancer
• Immunosuppression
• PTLD
• Post-transplant

• Colorectal Neoplasms/epidemiology
• Female
• Humans
• Incidence
• Kidney Transplantation/adverse effects
• Liver
• Male
• Prognosis
• Prospective Studies
• Retrospective Studies
• Risk Factors

• Cancer
• Complication
• Liver transplant
• Neoplasms

• Adolescent
• Adult
• Aged
• Female
• Humans
• Incidence
• Italy
• Kaplan-Meier Estimate
• Liver Diseases/etiology
• Liver Diseases/pathology
• Liver Diseases/surgery
• Liver Transplantation
• Male
• Middle Aged
• Neoplasms/diagnosis
• Neoplasms/epidemiology
• Postoperative Complications/diagnosis
• Postoperative Complications/epidemiology
• Proportional Hazards Models
• Retrospective Studies
• Young Adult

• Solid organ transplantation; Tumor mutational burden; Cancer risk

• Cohort Studies
• Humans
• Incidence
• Leukemia, Myeloid, Acute
• Organ Transplantation/adverse effects
• Transplant Recipients

Improving long-term patient and graft survival after liver transplantation (LT) remains a major challenge. Compared to the early phase after LT, long-term morbidity and mortality of the recipients not only depends on complications immediately related to the graft function, infections, or rejection, but also on medical factors such as de novo malignancies, metabolic disorders (e.g., new-onset diabetes, osteoporosis), psychiatric conditions (e.g., anxiety, depression), renal failure, and cardiovascular diseases. While a comprehensive post-transplant care at the LT center and the connected regional networks may improve outcome, there is currently no generally accepted standard to the post-transplant management of LT recipients in Germany. We therefore described the structure and standards of post-LT care by conducting a survey at 12 German LT centers including transplant hepatologists and surgeons. Aftercare structures and form of cost reimbursement considerably varied between LT centers across Germany. Further discussions and studies are required to define optimal structure and content of post-LT care systems, aiming at improving the long-term outcomes of LT recipients.

• Germany
• aftercare structures
• liver transplantation
• liver transplantation center
• long-term outcome
• post-liver transplantation management

• Cancer recurrence
• Immunosuppression
• Liver transplantation
• Post-transplant malignancy
• de novo malignancy

Solid organ transplant recipients are at increased risk of malignancy. Pediatric transplant recipients particularly have a potentially higher risk given the young age of immunosuppression initiation. Posttransplant malignancies are the main cause of death in 5%–16% of liver transplantation patients. The frequency of de novo malignancies in pediatric liver transplant recipients has been reported to be 13%. Synovial sarcoma is a malignant mesenchymal neoplasm that has not been previously reported after liver transplantation. We report the case of an adolescent liver transplant recipient who was diagnosed with synovial sarcoma 14 years after liver transplantation.

• epidemiology
• guidelines
• post-transplant malignancy
• screening
• skin cancer
• solid organ transplantation

• Adult liver transplant
• Cancer
• Clinical operational tolerance
• De novo malignancies
• Graft rejection
• Immune system
• Immunosuppression minimization
• Immunosuppression weaning
• Pediatric liver transplant

• Adult
• Allografts/immunology
• Child
• Graft Rejection/immunology
• Graft Rejection/prevention & control
• Humans
• Immune Tolerance/drug effects
• Immunosuppression Therapy/standards
• Immunosuppressive Agents/administration & dosage
• Immunosuppressive Agents/adverse effects
• Incidence
• Liver/immunology
• Liver Transplantation/adverse effects
• Neoplasms/epidemiology
• Neoplasms/immunology
• Neoplasms/prevention & control
• Patient Selection
• Postoperative Complications/epidemiology
• Postoperative Complications/immunology
• Postoperative Complications/prevention & control
• Withholding Treatment/standards

• cancer/malignancy/neoplasia: risk factors
• clinical decision-making
• clinical research/practice
• guidelines
• hematology/oncology
• obstetrics and gynecology
• organ transplantation in general

Individuals after solid organ transplant may develop secondary malignancies. In our clinical practice, we noted an increasing number of individuals who developed colorectal cancers after solid organ transplantation. The primary aim of this study was to describe the characteristics and outcomes of the patients who developed colorectal cancer after solid organ transplant.

Data was gathered and merged from several registries at Mayo Clinic to identify all patients who received a diagnosis of colon or rectal cancer and solid organ transplant. Continuous variables were summarized as mean (standard deviation) and median (range), while categorical variables were reported as frequency (percentage). Time to colorectal cancer after transplant and overall survival after cancer diagnosis were estimated using Kaplan-Meier method.

Initially, 115 colorectal cancer patients who also had a transplant were identified. The diagnosis of colorectal cancer was noted after solid organ transplant in 63 patients. The mean age at transplant was 57 years. Majority had received a kidney transplant (44.4%) followed by liver (36.5%). The median time to develop colorectal cancer was 59.3 months (range: 4.4-251.4 months). 15 (24.6%) were stage 4 at diagnosis and 13 (21.3%) had stage 3 colorectal cancer. Median overall survival was 30.8 months; 5-, 10- and 15-year survival were noted to be 42.5%, 17.9%, and 7.5%, respectively. None of the stage 4 patients were alive at 5 years; 5-year survival rate for stage 1, 2, and 3 patients was 77%, 50%, and 42%, respectively.

Our study reports on one of the largest cohorts of patients of colorectal cancer that developed the cancer after solid organ transplant. Survival is extremely poor for advanced cases. However, long-term survivors are noted who developed the cancer at a relatively early stage. Colorectal screening recommendations may need to be revised for patients after solid organ transplant.

• Adolescent
• Adult
• Age Factors
• Child
• Child, Preschool
• Female
• Humans
• Incidence
• Infant
• Infant, Newborn
• Liver Transplantation/adverse effects
• Male
• Neoplasms/diagnosis
• Neoplasms/epidemiology
• Registries
• Risk Factors
• Scandinavian and Nordic Countries/epidemiology
• Time Factors
• Treatment Outcome
• Young Adult