Open AccessIncidence and prognosis of cancer following heart transplantation using RATG induction therapy
Author(s) -
ElHamamsy Ismaïl,
Stevens LouisMathieu,
Carrier Michel,
Pelletier Guy,
White Michel,
Tremblay Francine,
Perrault Louis P.
Publication year - 2005
Publication title -
transplant international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.998
H-Index - 82
eISSN - 1432-2277
pISSN - 0934-0874
DOI - 10.1111/j.1432-2277.2005.00203.x
Subject(s) - medicine , immunosuppression , transplantation , heart transplantation , incidence (geometry) , prostate cancer , prospective cohort study , cancer , oncology , surgery , physics , optics
Summary Cancer limits survival following heart transplantation. The study's objectives were to evaluate the incidence and risk factors for cancers after heart transplantation and to assess the association between i.v. thymoglobuline induction therapy [rabbit antithymocyte immunoglobulin, (RATG)] and neoplasia. From 1982 to 2002, prospective data were gathered for 207 heart transplant recipients. Except from 1982 to 1987, all patients received a 3‐day course of i.v. RATG following transplantation. Forty‐three malignant neoplasms (21%) were diagnosed. The most common were: skin (42%), lung (12%), prostate (9%), genitourinary (9%) and lymphoma (5%). Mean length of follow‐up after transplantation was 99 ± 57 months. Mean survival after diagnosis was 52 ± 44 months. Multivariate analysis showed no significant increase in the incidence of cancer with recipient age, sex, number of rejection episodes, the type of immunosuppression or the use of RATG. Patients receiving RATG developed their malignancies significantly earlier after transplantation ( P =0.007) and succumbed faster after the diagnosis ( P = 0.06). Cancer is a limiting event for long‐term survival after heart transplantation. No individual risk factors allow predicting its development. In the present cohort, RATG does not have carcinogenic effects following transplantation, but is associated with a more precocious development of malignancies.