A Case of Pancreatic Cancer After Heart Transplantation

Abstract

SummaryMalignancy is not uncommon with immunosuppressive therapy, but pancreatic cancer is infrequently complicated in recipients of heart transplantation. Here we report a transplant case diagnosed with pancreatic cancer 4 years and 8 months after the heart transplantation. We changed the immunosuppressive regimen after the malignancy was detected, and administered everolimus along with chemotherapy using S-1, an oral fluoropyrimidine prodrug. The patient lived for 8 months after the diagnosis, and received metallic stenting for the biliary and duodenal obstruction. Also, to the best of our knowledge, this is the first report about chemotherapy and endoscopic intervention for pancreatic cancer in a heart transplantation patient. (Int Heart J 2012; 53: 205-207)

How Should We Treat Early Post-Transplant Lymphoproliferative Disease After Heart Transplantation?

“…The new immunosuppressant EVL, which is a mammalian target of rapamycin, has recently been demonstrated to have various advantages in terms of its prophylactic effect of CMV infection, 8,13) suppressive effect of cardiac allograft vasculopathy, [14][15][16] anti-malignancy effect, 17,18) and maintenance of renal function, 19) and subsequently its use has increased around the world. Although EVL has been reported to have a prophylactic effect towards PTLD, 18) it may not necessarily protect the development of early-PTLD completely considering the findings in the present patient.…”

Everolimus Attenuates Myocardial Hypertrophy and Improves Diastolic Function in Heart Transplant Recipients

“…[16][17][18][19][20] Recent clinical studies including ours also demonstrated the suppressive effects of EVL in cardiac allograft vasculopathy and post-transplant malignancy. [21][22][23][24][25] Considering that both SRL and EVL are mTOR inhibitors, EVL may also have a repressive effect on LVM. We here analyzed the relationship between EVL and LVM regression in Japanese HTx recipients.…”