Incidence,screening,and management of de novo malignancies in liver transplant patients:A review  

作　　者：Anmol Singh Carol Singh Armaan Dhaliwal Navdeep Singh Vikash Kumar Aalam Sohal Jonathan Schneider 

机构地区：[1]Department of Medicine,Tristar Centennial Medical Center,Nashville,TN 37203,United States [2]Department of Medicine,Dayanand Medical College and Hospital,Ludhiana 141001,Punjab,India [3]Division of Hematology and Oncology,Lehigh Valley Health Network,Allentown,PA 18103,United States [4]Department of Medicine,Government Medical College,Amritsar 143001,Punjab,India [5]Division of Gastroenterology,Creighton University School of Medicine,Phoenix,AZ 85012,United States [6]Division of Gastroenterology,Tristar Centennial Medical Center,Nashville,TN 37203,United States

出　　处：《World Journal of Transplantation》2025年第3期16-31,共16页世界移植杂志(英文)

摘　　要：Liver transplantation(LT)is the definitive treatment for end-stage liver disease,acute liver failure,and liver cancer.Although advancements in surgical techniques,postoperative care,and immunosuppressive therapies have significantly improved outcomes,the long-term use of immunosuppression has increased the risk of complications,including infections,cardiovascular disease,and cancer.Among these,de novo malignancies(DNMs)are a major concern,accounting for 20%-25%of deaths in LT recipients surviving beyond the early post-transplant period.Non-melanoma skin cancers,particularly squamous cell carcinoma are the most prevalent DNMs.Other significant malignancies include Kaposi's sarcoma,post-transplant lymphoproliferative disorders,and various solid organ cancers,including head and neck cancers.Compared to the general population,LT patients face a twofold increase in solid organ malignancies and a 30-fold increase in lymphoproliferative disorders.Risk factors for DNM include chronic immunosuppression,alcohol or tobacco use,viral infections,and underlying liver disease.Emerging evidence emphasizes the importance of tailored cancer screening and prevention strategies,including regular dermatological examinations,targeted screenings for high-risk cancers,and patient education on lifestyle modifications.Early detection through enhanced surveillance protocols has been shown to improve outcomes.Management of DNMs involves a combination of standard oncological therapies and adjustments to immunosuppressive regimens,with promising results from the use of mTOR inhibitors in select patients.The review highlights the critical need for ongoing research to refine risk stratification,optimize screening protocols,and improve treatment approaches to mitigate the burden of DNMs in LT recipients.By implementing personalized preventive and therapeutic strategies,we can enhance long-term outcomes and quality of life for this vulnerable population.

关 键 词：Liver transplant De novo malignancy IMMUNOSUPPRESSION Post-transplant lymphoproliferative disorder SCREENING Squamous cell cancer 

分 类 号：R73[医药卫生—肿瘤]