TY - JOUR
T1 - Outcomes of organ transplantation from donors with a cancer history
AU - Huang, Shanzhou
AU - Tang, Yunhua
AU - Zhu, Zebin
AU - Yang, Jie
AU - Zhang, Zhiheng
AU - Wang, Linhe
AU - Sun, Chengjun
AU - Zhang, Yixi
AU - Zhao, Qiang
AU - Chen, Maogen
AU - Wu, Linwei
AU - Wang, Dongping
AU - Ju, Weiqiang
AU - Guo, Zhiyong
AU - He, Xiaoshun
N1 - Funding Information:
* These authors contributed equally to the article and should be considered co-first authors Xiaoshun He, e-mail: [email protected], Zhiyong Guo, e-mail: [email protected], Weiqiang Ju, e-mail: [email protected] This study was supported by the National Natural Science Foundation of China (81373156, 81471583 and 81570587), the Special Fund for Science Research by the Ministry of Health (201302009), the Key Clinical Specialty Construction Project of National Health and Family Planning Commission of the People’s Republic of China, the Guangdong Provincial Key Laboratory Construction Projection on Organ Donation and Transplant Immunology (2013A061401007), Guangdong Provincial International Cooperation Base of Science and Technology (Organ Transplantation) (2015B050501002), Guangdong Provincial Natural Science Funds for Major Basic Science Culture Project (2015A030308010), Guangdong Provincial Natural Science Funds for Distinguished Young Scholars (2015A030306025), Special Support Program for Training High-level Talent in Guangdong Province (2015TQ01R168), Pearl River Nova Program of Guangzhou (201506010014), and the Science and Technology Program of Guangzhou (201704020150)
Publisher Copyright:
© Med Sci Monit, 2018.
PY - 2018/2/18
Y1 - 2018/2/18
N2 - BACKGROUND The inherent challenges of selecting an acceptable donor for the increasing number and acuity of recipients has forced programs to take increased risks, including accepting donors with a cancer history (DWCH). Outcomes of organ transplantation using organs from DWCH must be clarified. We assessed transplant outcomes of recipients of organs from DWCH. MATERIAL AND METHODS Retrospective analysis of the Scientific Registry of Transplant Recipients data from January 1, 2000 to December 31, 2014 identified 8385 cases of transplants from DWCH. A Cox-proportional hazard regression model and log-rank test were used to compare patient survival and hazard levels of various cancer types. RESULTS DWCH was an independent risk factor of 5-year patient survival (HR=1.089, 95% CI: 1.009-1.176, P=0.03) and graft survival (HR=1.129, 95% CI: 1.056-1.208, P<0.01) in liver and heart transplantation (patient survival: HR=1.112, 95% CI: 1.057-1.170, P<0.01; graft survival: HR=1.244, 95% CI: 1.052-1.472, P=0.01). There was no remarkable difference between the 2 groups in kidney and lung transplantation. Donors with genitourinary and gastrointestinal cancers were associated with inferior outcomes in kidney transplantation. Transplantation from donors with central nervous system cancer resulted in poorer survival in liver transplant recipients. Recipients of organs from donors with hematologic malignancy and otorhinolaryngologic cancer had poorer survival following heart transplantation. CONCLUSIONS Under the current donor selection criteria, recipients of organs from DWCH had inferior outcomes in liver and heart transplantation, whereas organs from DWCH were safely applied in kidney and lung transplantation. Specific cancer types should be cautiously evaluated before performing certain types of organ transplantation.
AB - BACKGROUND The inherent challenges of selecting an acceptable donor for the increasing number and acuity of recipients has forced programs to take increased risks, including accepting donors with a cancer history (DWCH). Outcomes of organ transplantation using organs from DWCH must be clarified. We assessed transplant outcomes of recipients of organs from DWCH. MATERIAL AND METHODS Retrospective analysis of the Scientific Registry of Transplant Recipients data from January 1, 2000 to December 31, 2014 identified 8385 cases of transplants from DWCH. A Cox-proportional hazard regression model and log-rank test were used to compare patient survival and hazard levels of various cancer types. RESULTS DWCH was an independent risk factor of 5-year patient survival (HR=1.089, 95% CI: 1.009-1.176, P=0.03) and graft survival (HR=1.129, 95% CI: 1.056-1.208, P<0.01) in liver and heart transplantation (patient survival: HR=1.112, 95% CI: 1.057-1.170, P<0.01; graft survival: HR=1.244, 95% CI: 1.052-1.472, P=0.01). There was no remarkable difference between the 2 groups in kidney and lung transplantation. Donors with genitourinary and gastrointestinal cancers were associated with inferior outcomes in kidney transplantation. Transplantation from donors with central nervous system cancer resulted in poorer survival in liver transplant recipients. Recipients of organs from donors with hematologic malignancy and otorhinolaryngologic cancer had poorer survival following heart transplantation. CONCLUSIONS Under the current donor selection criteria, recipients of organs from DWCH had inferior outcomes in liver and heart transplantation, whereas organs from DWCH were safely applied in kidney and lung transplantation. Specific cancer types should be cautiously evaluated before performing certain types of organ transplantation.
KW - Organ transplantation
KW - Survival analysis
KW - Tissue donors
KW - Neoplasms/pathology
KW - Follow-Up Studies
KW - Humans
KW - Proportional Hazards Models
KW - Probability
KW - Graft Survival
KW - Organ Transplantation
KW - Treatment Outcome
KW - Incidence
KW - Survival Analysis
KW - Tissue Donors
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U2 - 10.12659/MSM.909059
DO - 10.12659/MSM.909059
M3 - Article
C2 - 29455213
AN - SCOPUS:85042442760
SN - 1234-1010
VL - 24
SP - 997
EP - 1007
JO - Medical Science Monitor
JF - Medical Science Monitor
ER -