European Journal of Cardio-Thoracic Surgery, Vol 12, 101-106, Copyright © 1997 by European Association for Cardio-thoracic Surgery
Malignant neoplasms following cardiac transplantation
A Curtil, J Robin, F Tronc, J Ninet, P Boissonnat and G Champsaur
Service de Chirurgie Thoracique et Cardiovasculaire C, Louis Pradel Cardiovascular Hospital, Lyon, France. gerard.champsaur@univ-lyon1.fr
OBJECTIVE: Malignancies have long been recognized as a complication of long
lasting immunosuppressive therapy. We reviewed our experience to
investigate the incidence and the spectrum of non cutaneous de novo
malignant neoplasms. METHODS: Between March 1987 and March 1996, 296
patients underwent 303 cardiac transplantation in our service. The
population at risk consists of all patients surviving more than 1 month
after transplantation, leading to a total of 267 patients. A triple-
immunosuppressive therapy was employed. Moderate doses of antilymphocyte
globulin was used as an induction immunotherapy. RESULTS: Neoplasms
developed in 18 (6.7%) of the 267 patients at risk. Seventeen patients were
male. Mean age was 56 +/- 7 years. Fourteen patients (78%) reported a
significant smoking history. Mean interval between transplantation and
clinical diagnosis was 36 months. Lung neoplasms (especially
adenocarcinoma) were the most commonly encountered tumors (11 of 268
patients, 4.1%). Three Non-Hodgkins' Lymphoma (NHL) were identified (1.1%).
No Kaposi's sarcoma were diagnosed. Mean survival after a diagnostic of
tumor was 11.7 months. CONCLUSIONS: The incidence of NHL is low in our
transplant recipients. Conversely, we observed a high incidence of lung
neoplasms (especially adenocarcinoma) which can be correlated with a heavy
cigarette use in the study population.
