Solid Organ Transplant and Cancer Risk

Autor: Carolyn Vachani, MSN, RN
Fecha de la última revisión: July 26, 2022

Am I at risk for cancer after my solid organ transplant?

People who have had solid organ transplants (lung, heart, liver, kidney) have a higher risk of developing cancer. There are several things that may cause this increase such as:

  • Immunosuppressive medicines that are used to prevent the immune system from rejecting the organ.
  • Infection with viruses known to cause cancer (HPV, Epstein Barr, H. Pylori).
  • Some of the things that can cause your organ to fail also increase cancer risk such as smoking and alcohol use.
  • Some diseases that cause organ failure also cause a higher risk of cancer such as kidney failure and cirrhosis.

What cancers happen after a transplant?

The cancers that occur at higher rates in people who receive transplants include:

  • Non-melanoma skin cancers (squamous cell and basal cell).
  • Non-Hodgkin lymphoma or Post-transplant lymphoproliferative disorders (PTLD).
  • Kaposi sarcoma.
  • Cancers of the anogenital area (anus, vulva, penis).
  • Head & neck cancers (lip, oral, and tonsil are most common).
  • Kidney cancer.
  • Lung cancer.
  • Hodgkin lymphoma.
  • Thyroid cancer.
  • Stomach cancer.
  • Liver cancer.
  • Colorectal cancer.

How can I reduce my risk of cancer?

There are things you can do to lower your risk of cancer after a transplant. Certain immunosuppressive medications can increase the risk more than others. Higher doses of immunosuppressive medications can also increase the risk. Your transplant team balances the need to prevent organ rejection with cancer risk.

Many of these cancers have other risk factors that you can change with healthy lifestyle choices, such as:

  • Practice sun safety – or sun avoidance.
  • Do not use tobacco products. Talk to your provider about help quitting if you do.
  • Limit your alcohol intake, if at all.
  • Reduce your risk of HPV through safe sex practices.
  • Keep up with your doctor visits for other health issues.

Cancer Screening

Because your risk of some cancers is higher, it is important for you to have any cancer screenings recommended by your team. These screenings are not the same as for the general public and usually include screening tests for more cancers than the public would have. Transplant experts recommend cancer screenings depending on the organ you got and your own risk factors. Talk with your transplant team about what cancer screening tests you should have and how often.

Referencias

Acuna S. A. (2018). Etiology of increased cancer incidence after solid organ transplantation. Transplantation reviews (Orlando, Fla.), 32(4), 218–224. https://doi.org/10.1016/j.trre.2018.07.001

Au, E., Wong, G., & Chapman, J. R. (2018). Cancer in kidney transplant recipients. Nature reviews. Nephrology, 14(8), 508–520. https://doi.org/10.1038/s41581-018-0022-6Brennan, D. C., Rodeheffer, R. J., & Ambinder, R. F. (2011). Development of malignancy following solid organ transplantation. UpTo-Date. Wolters Kluwer, www. uptodate. com (20 August 2012, date last accessed).

Collett, D., Mumford, L., Banner, N. R., Neuberger, J., & Watson, C. (2010). Comparison of the incidence of malignancy in recipients of different types of organ: a UK Registry audit. American Journal of Transplantation, 10(8), 1889-1896.

Dharnidharka, V. R. (2018). Comprehensive review of post–organ transplant hematologic cancers. American Journal of Transplantation, 18(3), 537-549.

Engels, E. A., Pfeiffer, R. M., Fraumeni, J. F., Kasiske, B. L., Israni, A. K., Snyder, J. J., ... & Copeland, G. (2011). Spectrum of cancer risk among US solid organ transplant recipients. Jama, 306(17), 1891-1901.

Fernberg, P., Edgren, G., Adami, J., Ingvar, Å., Bellocco, R., Tufveson, G., ... & Lindelöf, B. (2011). Time trends in risk and risk determinants of non‐Hodgkin lymphoma in solid organ transplant recipients. American journal of transplantation, 11(11), 2472-2482.

Neuburg, M. (2007). Transplant-associated skin cancer: role of reducing immunosuppression. Journal of the National Comprehensive Cancer Network, 5(5), 541-549.

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