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Pretransplant solid organ malignancy and organ transplant candidacy: A consensus expert opinion statement
Authors:David P Al-Adra  Laura Hammel  John Roberts  E Steve Woodle  Deborah Levine  Didier Mandelbrot  Elizabeth Verna  Jayme Locke  Jonathan D'Cunha  Maryjane Farr  Deirdre Sawinski  Piyush K Agarwal  Jennifer Plichta  Sandhya Pruthi  Deborah Farr  Richard Carvajal  John Walker  Fiona Zwald  Thomas Habermann  Morie Gertz  Philip Bierman  Don S Dizon  Carrie Langstraat  Talal Al-Qaoud  Scott Eggener  John P Richgels  George J Chang  Cristina Geltzeiler  Gonzalo Sapisochin  Rocco Ricciardi  Alexander S Krupnick  Cassie Kennedy  Nisha Mohindra  David P Foley  Kymberly D Watt
Affiliation:1. Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin;2. Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin;3. Department of Surgery, University of California San Francisco, San Francisco, California;4. Department of Surgery, University of Cincinnati, Cincinnati, Ohio;5. Department of Medicine, University of Texas Health San Antonio, San Antonio, Texas;6. Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin;7. Department of Medicine, New York-Presbyterian/Columbia, New York, New York;8. Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama;9. Department of Surgery, Mayo Clinic, Phoenix, Arizona;10. Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania;11. Department of Urology, University of Chicago, Chicago, Illinois;12. Department of Surgery, Duke University School of Medicine, Durham, North Carolina;13. Department of Medicine, Mayo Clinic, Rochester, Minnesota;14. Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas;15. Department of Medicine, University of Alberta, Edmonton, AB, Canada;16. Piedmont Transplant Institute, Piedmont Atlanta Hospital, Atlanta, Georgia;17. Hematology Division, Mayo Clinic, Rochester, Minnesota;18. Department of Medicine, University of Nebraska Medical Center, Omaha, Nebraska;19. Lifespan Cancer Institute and Brown University, Providence, Rhode Island;20. Departments of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota;21. Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas;22. Department of Surgery, University of Toronto, Toronto, ON, Canada;23. Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts;24. Department of Surgery, University of Virginia, Charlottesville, Virginia;25. Department of Medicine, Northwestern University, Chicago, Illinois
Abstract:Patients undergoing evaluation for solid organ transplantation (SOT) often have a history of malignancy. Although the cancer has been treated in these patients, the benefits of transplantation need to be balanced against the risk of tumor recurrence, especially in the setting of immunosuppression. Prior guidelines of when to transplant patients with a prior treated malignancy do not take in to account current staging, disease biology, or advances in cancer treatments. To develop contemporary recommendations, the American Society of Transplantation held a consensus workshop to perform a comprehensive review of current literature regarding cancer therapies, cancer stage-specific prognosis, the kinetics of cancer recurrence, and the limited data on the effects of immunosuppression on cancer-specific outcomes. This document contains prognosis based on contemporary treatment and transplant recommendations for breast, colorectal, anal, urological, gynecological, and nonsmall cell lung cancers. This conference and consensus documents aim to provide recommendations to assist in the evaluation of patients for SOT given a history of a pretransplant malignancy.
Keywords:cancer / malignancy / neoplasia  clinical research / practice  editorial / personal viewpoint  organ transplantation in general  patient safety  recipient selection
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