Malignancy after Heart Transplantation: A Systematic Review of the Incidence and Risk Factors Compared with Other Solid Organ Transplants

Abstract

The continuing improvements in heart transplant (HT) outcomes have increased the risk of developing complications, such as post-transplant malignancy (PTM). Our aims are to focus on the incidence and risk factors in PTM in heart transplant recipients and compare with other solid organ transplantations (SOT). In 20 publications analyzed, the incidence of PTM in individuals undergoing SOT ranges from 4.1% to 16.3%, representing a 2 to 4-fold overall increased risk of cancer over the general population. It seems that the incidence of cancer risk is probably higher in HT than SOT recipients. Cutaneous carcinomas, post-transplant lymphoproliferative disorders (PTLD), carcinomas of lung and liver represent the four most common malignancies in this specific post-transplant population. It is also evident that the risk factors in developing PTM in HT recipients include immunosuppressive therapy, viral infection, older age, tobacco smoking, and unprotected sun-exposure. Transplant physicians should probably increase the threshold of attention for cancer risk surveillance in addition to anti-rejection therapy for graft survivals.