06. PTC: Cancer Risks for Lung Recipients

06. PTC: Cancer Risks for Lung Recipients

Lung Transplant Recipients at Higher Risk for Lung Cancer Than General Population

A recent analysis of the Transplant Cancer Match (TCM) Study underscores how the risk for lung cancer is increased in recipients of lung transplants compared with individuals in the general public (Am J Transplant. 2018 Dec 18. Epub ahead of print).lungtransplant

“Lung transplant recipients have an increased risk of lung cancer that is poorly understood. Prior studies are largely descriptive and single-center, and have not examined risk factors or outcomes in this population,” said Matthew A. Triplette, MD, MPH, Assistant Professor, Department of Medicine, University of Washington, Seattle, and colleagues.

click here for full article

Overview

People who have received a lung transplant have an increased risk of developing cancer at a later date. This would usually be one of the following:

Because of this increased risk, regular check-ups for these sorts of cancers may be recommended.

Post-transplantation lymphoproliferative disorder

After having a lung transplant, your risk of developing a lymphoma (usually a non-Hodgkin lymphoma) is increased. This is known as post-transplantation lymphoproliferative disorder (PTLD).
PTLD occurs when a viral infection (usually the Epstein-Barr virus) develops as a result of the immunosuppressants that are used to stop your body rejecting the new organ.
PTLD affects around one in 20 people who have a lung transplant. Most cases occur within the first year of the transplant. It can usually be treated by reducing or withdrawing immunosuppressant therapy.

Action Plan

Lung transplantation has come a long way in recent years and will advance even more as the development of ex vivo lung perfusion becomes common practice, making more lungs available for transplant. 

Lung transplantation is the only life–saving therapy for patients with certain types of end–stage lung disease; however the procedure has limited availability because not all donor lungs are safe for transplantation. This shortage of donor lungs results in the death of 20 percent of lung transplant candidates awaiting transplant.

exvivolungEx vivo lung perfusion (EVLP) is an innovative therapy applied to donor lungs outside of the body before transplantation that improves organ quality and makes lungs that were previously unsuitable safe for transplant.

The process involves a three-to-four-hour period during which the donated lungs are placed inside a sterile plastic dome attached to a ventilator, pump, and filters. The lungs are maintained at normal body temperature and treated with a bloodless solution that contains nutrients, proteins, and oxygen. This can reverse lung injury and remove excess lung water. During the process, lung function is evaluated continuously on several key indicators. Once determined to be suitable, the lungs are transplanted into a waiting patient.

View a YouTube video on that ex vivo lung perfusion subject here:  Ex Vivo Lung Perfusion
And for more click to see this TED talk: TED Med 2013

Most Common Post-Transplant Cancer Types

Each type of organ transplant comes with cancer risks that may be different due to unique biology of that organ, or more commonly, due to the different drug protocals - both drug type and dosage - used for each type of transplant.  

In this LOOK section you will find topics...

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    DISCLAIMER: The content of this TRIO post-transplant cancer Web site is not influenced by sponsors. The site is designed primarily for use by transplant recipients and their supporters. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with your transplant team or a physician skilled in cancer and your organ type if you suspect you are ill.