Post-transplant malignancies in pediatric liver transplant recipients: Experience of two centers in Turkey

Karakoyun, Miray; Onen, Sebnem; Baran, Maşallah; Çakır, Murat; Ecevıt, Çiğdem; Kılıç, Murat; Kantar, Mehmet; Aksoylar, Serap; Özgenç, Funda; Aydoğdu, Sema

doi:10.5152/tjg.2017.17089

Cited by 10 publications

(10 citation statements)

References 30 publications

(34 reference statements)

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“…As in adults, the major risk factors for DNMs after pediatric OLT include IS regimens as well as viral infections such as EBV, cytomegalovirus, human papilloma virus and human herpesvirus-8[75]. Due to the paucity of data in the pediatric population, data on DNMs after OLT in children are reported mainly in registry transplant studies including other solid organ (kidney, lung, heart)[76,77]. Therefore, records on the incidence and types of DNMs after pediatric OLT are limited to single case series and mainly related to PTLDs.…”

Section: Resultsmentioning

confidence: 99%

De novo malignancies after liver transplantation: The effect of immunosuppressionn-personal data and review of literature

Manzia¹,

Angelico²,

Gazia³

et al. 2019

WJG

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BACKGROUNDImmunosuppression has undoubtedly raised the overall positive outcomes in the post-operative management of solid organ transplantation. However, long-term exposure to immunosuppression is associated with critical systemic morbidities. De novo malignancies following orthotopic liver transplants (OLTs) are a serious threat in pediatric and adult transplant individuals. Data from different experiences were reported and compared to assess the connection between immunosuppression and de novo malignancies in liver transplant patients.AIMTo study the role of immunosuppression on the incidence of de novo malignancies in liver transplant recipients.METHODSA systematic literature examination about de novo malignancies and immunosuppression weaning in adult and pediatric OLT recipients was described in the present review. Worldwide data were collected from highly qualified institutions performing OLTs. Patient follow-up, immunosuppression discontinuation and incidence of de novo malignancies were reported. Likewise, the review assesses the differences in adult and pediatric recipients by describing the adopted immunosuppression regimens and the different type of diagnosed solid and blood malignancy.RESULTSEmerging evidence suggests that the liver is an immunologically privileged organ able to support immunosuppression discontinuation in carefully selected recipients. Malignancies are often detected in liver transplant patients undergoing daily immunosuppression regimens. Post-transplant lymphoproliferative diseases and skin tumors are the most detected de novo malignancies in the pediatric and adult OLT population, respectively. To date, immunosuppression withdrawal has been achieved in up to 40% and 60% of well-selected adult and pediatric recipients, respectively. In both populations, a clear benefit of immunosuppression weaning protocols on de novo malignancies is difficult to ascertain because data have not been specified in most of the clinical experiences.CONCLUSIONThe selected populations of tolerant pediatric and adult liver transplant recipients greatly benefit from immunosuppression weaning. There is still no strong clinical evidence on the usefulness of immunosuppression withdrawal in OLT recipients on malignancies. An interesting focus is represented by the complete reconstitution of the immunological pathways that could help in decreasing the incidence of de novo malignancies and may also help in treating liver transplant patients suffering from cancer.

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Section: Resultsmentioning

confidence: 99%

De novo malignancies after liver transplantation: The effect of immunosuppressionn-personal data and review of literature

Manzia¹,

Angelico²,

Gazia³

et al. 2019

WJG

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“…Cutaneous involvement of PTLD after liver transplantation is even rarer. To date, the only reported case is a 69‐year‐old man with primary cutaneous B‐cell PTLD who received a liver transplant 13 years earlier …”

Section: Discussionmentioning

confidence: 99%

“…To date, the only reported case is a 69-year-old man with primary cutaneous B-cell PTLD who received a liver transplant 13 years earlier. 6,9,[12][13][14][15] Currently, the mainstay of treatment for PTLD is reduction of immunosuppression (RIS). 1,2,5,7 Recovery of the recipient's immune system allows EBV-specific cytotoxic cells to proliferate and subsequently control B-cell proliferation.…”

mentioning

confidence: 99%

Cutaneous involvement of polymorphic post‐transplant lymphoproliferative disorder in a child after liver transplantation

Chen

Lin

Kuo

et al. 2019

Pediatric Dermatology

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Post‐transplantation lymphoproliferative disorder (PTLD) is one of the most common de novo malignancies in patients who receive immunosuppressive therapy after solid organ transplantation. We report a case of a 5‐year‐old girl who presented with indurated violaceous skin nodules 3.5 years post–liver transplantation, diagnosed as polymorphic PTLD, also involving Waldeyer's ring, spleen, and multiple lymph nodes. Through reduction of immunosuppression, most of the lesions resolved and the liver allograft was preserved.

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“…Among the pediatric population, PTLD is the most common cause of de novo malignancy following organ transplantation [ 3 , 4 ]. Unlike adult patients, de novo solid malignant tumors are rare in pediatric patients receiving organ transplantation, with only two cases involving liver sarcoma and hepatocellular carcinoma having been reported [ 5 , 6 ]. Meanwhile, no report has been available regarding the development of gastric cancer after LTx for BA.…”

Section: Introductionmentioning

confidence: 99%

De novo gastric cancer developing after liver transplantation from deceased donor for biliary atresia: a case report

et al. 2021

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Background Apart from Kasai’s procedure, liver transplantation (LTx) has dramatically improved the outcome of children with biliary atresia (BA). However, de novo malignancy has been reported to be one of the major causes of late mortality after LTx among adults. We report a rare case of de novo gastric cancer developing after LTx for BA received during childhood. Case presentation A 21-year-old male patient who had undergone LTx for BA at age 2 years occasionally visited our outpatient clinic due to symptoms of epigastric pain and dysphagia. Endoscopic examination and computed tomography revealed advanced gastric cancer at the gastroesophageal junction with multiple liver metastases. Despite systemic chemotherapy, the disease progressed, resulting in patient’s death 2 years after the diagnosis. Conclusions De novo malignancy in the absence of post-transplant lymphoproliferative disease is rare in pediatric patients who received LTx. To the best of our knowledge, no report has been available on the development of gastric cancer after LTx for BA during childhood. Primary physicians should therefore establish a follow-up plan for patients receiving LTx for BA considering the potential for the development of de novo malignancy, including gastric cancer, despite its rarity.

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Post-transplant malignancies in pediatric liver transplant recipients: Experience of two centers in Turkey

Cited by 10 publications

References 30 publications

De novo malignancies after liver transplantation: The effect of immunosuppressionn-personal data and review of literature

De novo malignancies after liver transplantation: The effect of immunosuppressionn-personal data and review of literature

Cutaneous involvement of polymorphic post‐transplant lymphoproliferative disorder in a child after liver transplantation

De novo gastric cancer developing after liver transplantation from deceased donor for biliary atresia: a case report

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