Malignancy after Lung Transplantation in Japan

S. Otani, M. Yamane, Y. Yokoyama, T. F. Chen-Yoshikawa, H. Oishi, J. Nakajima, I. Yoshino, T. Nagayasu, T. Shiraishi, M. Chida, Y. Shintani, H. Date, K. Okada, T. Oto

Research output: Contribution to journalArticle

Abstract

PURPOSE: Malignancy is one of the leading causes of death after organ transplantation. We conducted a national survey of malignancy after lung transplantation among all lung transplant centers in Japan. METHODS: All recipients who underwent lung transplantation since October 1998 until December 2017 in Japan were retrospectively reviewed. RESULTS: Malignant diseases developed in 41 (6.9%) of 596 lung transplant recipients in 388 brain-dead donor lung transplantation and 208 living donor lobar lung transplantation. Except recurrence of the original malignant diseases (n=4/596, 0.7%) and possible progression after transplantation in cancer-baring recipients (n=5/596, 0.8%), de novo malignancy occurred in 33 patients (5.5%). The most common de novo malignancy was lymphoproliferative disorder (n=16/34, 46%). Compared with the ISHLT registry, we observed far fewer skin cancer (n=1). In terms of the underlying disease for lung transplantation, interstitial pneumonitis (n=13/33, 39%) and lung complication after hematopoietic stem cell transplantation (n=10/33, 30%) were common, suggesting that long-term immunosuppression before and after transplantation has a negative impact on occurrence of de novo malignancy. The average time of occurrence after transplantation was 39 (±38) months. Death due to malignancy occurred in 11/33 (33%). The overall 5-year survival of patients with malignancies after lung transplantation was 49%. CONCLUSION: In Japan, the most common malignancy after lung transplantation was posttransplant lymphoproliferative disorder. Long-term immunosuppression before and after transplantation can have a negative impact on occurrence of de novo malignancy after lung transplantation.

Original languageEnglish
Pages (from-to)S383
JournalThe Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
Volume39
Issue number4
DOIs
Publication statusPublished - Apr 1 2020

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine
  • Transplantation

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    Otani, S., Yamane, M., Yokoyama, Y., Chen-Yoshikawa, T. F., Oishi, H., Nakajima, J., Yoshino, I., Nagayasu, T., Shiraishi, T., Chida, M., Shintani, Y., Date, H., Okada, K., & Oto, T. (2020). Malignancy after Lung Transplantation in Japan. The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation, 39(4), S383. https://doi.org/10.1016/j.healun.2020.01.493