Chapter 18 - History of cancer and transplant clearance: Considerations prior to transplantation

The evolution of research into solid organ transplantation is quietly revolutionizing the field of oncology and improving the perspectives on patients' outcomes diagnosed with advanced asymptomatic cancers. Enhancing immunotherapy and drug combinate regiments for treatment and downstaging, along with improving curative surgical measures, have created better opportunities for long-term survival outcomes. Regardless, patients with a history of cancer who later develop regional malignancies and require liver transplants (LTs) are a largely understudied population. Yet, they require vastly different observation criteria in study and treatment due to their record of previous carcinoma. Similarly, when distributing deceased donor organs, research into donors' medical history affecting the LT patient's outcomes has primarily relied on the American Association for the Study of Liver Disease (AASLD). However, there remains little literature on improving outcomes within these guidelines. This chapter aims to evaluate the related guidelines, bring to attention the considerations of preexisting cancer in different body systems for patients that require LT, and review how various cancer histories affect deceased donor versus living donor LT considerations.