De novo malignancies after liver transplantation: A major cause of late death

Fung, John J.; Jain, Ashok Kumar; Kwak, Eun Jeong; Kusne, Shimon; Dvorchik, Igor; Eghtesad, Bijan

doi:10.1053/jlts.2001.28645

Cited by 183 publications

(163 citation statements)

References 77 publications

(79 reference statements)

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“…Malignancies associated with chronic viral infection are more common such as EBV associated posttransplant lymphoproliferative disease (PTLD). 79 Also, there is a differential risk of post-transplant malignancies based on pre-transplant cause with alcoholic patients at a greater risk. 80 PTLD occurs due to uncontrolled lymphoproliferation of EBV infected cells in immunocompromised individual.…”

Section: Development Of De Novo Malignancies and Posttransplant Lymphmentioning

confidence: 99%

Current Status of Immunosuppression in Liver Transplantation

Choudhary

Saigal

Shukla

et al. 2013

Journal of Clinical and Experimental Hepatology

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With advancements in immunosuppressive strategies and availability of better immunosuppressive agents, survival rate following liver transplantation has improved significantly in the recent times. Besides improvements in surgical techniques, the most important factor that has contributed to this better outcome is the progress made in the field of immunosuppression. Over the last several years, the trend has changed to tailored immunosuppression with the aim of achieving optimal graft function while avoiding its undesirable side effects. Induction agents are no longer used routinely and the aim is to provide minimal immunosuppression in the maintenance phase. The present review discusses the various types of immunosuppressive agents, their mechanism of action, clinical utility, advantages and disadvantages, and their side effects in short and long-term. It also discusses about tailoring immunosuppression in presence of various situations such as renal dysfunction, metabolic syndrome, hepatitis C recurrence, cytomegalovirus infections and so on. The issue of chronic kidney disease and the available renal sparing immunosuppressive strategies has been particularly stressed upon. Finally, it discusses about the practical aspects of various immunosuppression regimens including drug monitoring. ( J CLIN EXP HEPATOL 2013;3:150-158)

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Section: Development Of De Novo Malignancies and Posttransplant Lymphmentioning

confidence: 99%

Current Status of Immunosuppression in Liver Transplantation

Choudhary

Saigal

Shukla

et al. 2013

Journal of Clinical and Experimental Hepatology

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“…12 Currently, long-term graft loss and death are not commonly related to rejection but are often due to age-related complications, such as cardiovascular disease and de novo cancers. 13,14 The rate of de novo cancers after LTx has been reported to range from 3% to 26%, [15][16][17][18] and the variation is partly due to the length of follow-up, different ways of reporting, and geographic variations in de novo malignancies. Although registry data of de novo cancers provide a valuable source for accounting for the various types of malignancies; these registries do not include the denominator of the population at risk.…”

Section: See Article On Page 1428mentioning

confidence: 99%

“…13 The rate of PTLD was examined in the same 1000-patient population for the same duration of follow-up used for de novo cancers: overall, 43 cases were identified. The rates of PTLD in the age groups of Յ18 years (n ϭ 166), Ͼ18 to Յ40 years (n ϭ 188), Ͼ40 to Յ 60 years (n ϭ 442), and Ͼ60 years (n ϭ 204) were 10.8%, 2.7%, 3.2%, and 2.9% respectively (Table 3).…”

Section: Ptld In Relation To the Age And Length Of Follow-upmentioning

confidence: 99%

Incidence of de novo cancer and lymphoproliferative disorders after liver transplantation in relation to age and duration of follow-up

2008

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“…[52][53][54] In a large, multicenter, long-term database study of 798 adult LT recipients, the probability of developing any de novo malignancy within 1, 5, and 10 years was 3.5%, 11.9%, and 21.7%, respectively. 52 One reason for this increased incidence is that the long-term use of immunosuppressive medications (particularly azathioprine and MMF) is thought to impair cancer surveillance mechanisms and create an environment for oncogenic viruses to thrive.…”

Section: Malignancymentioning

confidence: 99%

Long-term Medical Management of the Liver Transplant Recipient: What the Primary Care Physician Needs to Know

Singh

Watt

2012

Mayo Clinic Proceedings

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Recognition, management, and prevention of medical complications and comorbidities after liver transplant is the key to improved long-term outcomes. Beyond allograft-related complications, metabolic syndrome, cardiovascular disease, renal dysfunction, and malignancies are leading causes of morbidity and mortality in this patient population. Primary care physicians have an important role in improving outcomes of liver transplant recipients and are increasingly relied on for managing these complex patients. This review serves to assist the primary care physician in the long-term management issues of liver transplant recipients.

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De novo malignancies after liver transplantation: A major cause of late death

Cited by 183 publications

References 77 publications

Current Status of Immunosuppression in Liver Transplantation

Current Status of Immunosuppression in Liver Transplantation

Incidence of de novo cancer and lymphoproliferative disorders after liver transplantation in relation to age and duration of follow-up

Long-term Medical Management of the Liver Transplant Recipient: What the Primary Care Physician Needs to Know

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