Patients who have received a solid organ transplant, such askidney, liver, heart or lung, have an overall cancer risk that is double that of the general population, with anincreased risk for many different types of malignancies, accordingto a study in the November 2 issue of JAMA. "In 2010, a total of 28,664 transplants were performed in theUnited States, including 16,899 kidney transplants, 6,291 livertransplants, 2,333 heart transplants, and 1,770 lung transplants,"according to background information in the article. Solid organtransplant recipients have an increased cancer risk due toimmunosuppression and oncogenic viral infections. "A betterunderstanding of cancer risk in transplant recipients would helpclarify the role of the immune system, infections, and otherfactors in the development of malignancy, and could identifyopportunities to improve transplant safety." Eric A.
Engels, M.D., M.P.H., of the National Cancer Institute,Rockville, Md., and colleagues conducted a study to examine theoverall pattern of cancer following solid organ transplantation.The researchers used linked data on solid organ transplantrecipients from the U.S. Scientific Registry of TransplantRecipients (1987-2008) and 13 state and regional cancer registriesto determine relative and absolute cancer risk in transplantrecipients compared with the general population. The data included 175,732 transplants (39.7 percent of the U.S.total during 1987-2008). Most of the included recipients were male(60.9 percent), and the median (midpoint) age at transplant was 47years. The most common transplanted organs were kidney (58.4percent), liver (21.6 percent), heart (10.0 percent), and lung (4.0percent).
Transplant recipients were linked to 10,656 malignancydiagnoses during follow-up, with analysis indicating an overalldoubling of cancer risk compared with the general population. Risk was increased for 32 different malignancies, some related toknown infections (e.g., anal cancer , Kaposi sarcoma ) and others unrelated to infection (e.g., melanoma , thyroid and lip cancers). The most common malignancies withelevated risk were non-Hodgkin lymphoma (n = 1,504) and cancers of the lung (n = 1,344), liver (n = 930),and kidney (n = 752), which together comprised 43 percent of allcancer cases in transplant recipients compared with 21 percent inthe U.S. general population.
Non-Hodgkin lymphoma risk was elevated, compared with the generalpopulation, for recipients of all organ types. For lung cancer , the elevated risk was greatest among lung recipients but also waspresent for recipients of other organs (kidney, liver, heart). Liver cancer risk was only elevated for liver recipients. Kidney cancer risk was highest in kidney recipients, but was also elevated amongliver and heart recipients. "In conclusion, this large-scale registry linkage study documents awide spectrum of cancer risk among transplant recipients.
Somemalignancies arise from the loss of immunologic control ofoncogenic viruses, but others are unrelated to known infections.Additional contributing factors for some cancers may include othereffects of chronic immune disturbance or inflammation, underlyingmedical conditions, or medication toxicity. Our findings shouldstimulate research into carcinogenic mechanisms associated withorgan transplantation. The elevated risk for a broad range ofmalignancies among transplant recipients, coupled with improvementsin long-term survival, should encourage further development ofapproaches to prevention and early detection of cancer targeted tothis population," the authors write. Additional References Citations. I am Furniture & Furnishings writer, reports some information about simplicity travel swing , slate end table.
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