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Transplantation |

Malignancy Following Lung Transplantation

Raid Abu-Awwad*, MBBS; Ammar Khanhour, MD; Robert Chapman, MD; Alan Betensley, MD
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Henry Ford Hospital - Department of Internal Medicine, Detroit, MI


Chest. 2012;142(4_MeetingAbstracts):1100A. doi:10.1378/chest.1390071
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Abstract

SESSION TYPE: Lung Transplantation Posters

PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM

PURPOSE: Malignancy has been shown to be a frequent complication of solid organ transplantation. It has been reported more commonly in lung transplant patients compared to other solid organ transplant recipients presumably due to the greater degree of immunosuppression required for these patients; the International Society for Heart and Lung Transplantation (ISHLT) reported that malignancies account for 15% of all deaths of lung transplant patients between 5 and 10 years after transplant. The aim of this study is to describe malignancies observed in patients who underwent lung transplantation in a single, large tertiary center.

METHODS: A retrospective analysis of the medical records of all adult recipients of lung allografts transplanted at Henry Ford Hospital between 1994 and 2011 was performed. Main variables included age at transplant, type of transplant, smoking status and type of malignancy. Study end point was development of malignancy. Patients surviving less than 3 months were excluded from the final analysis. T-test and Chi-square tests were used in the statistical analysis.

RESULTS: 145 patients received lung transplants with 136 patients surviving at least 3 months. Of the 136 cases included; 31 (23%) patients developed post-transplant malignancy as follows: skin cancer in 17, lung cancer (in the native lung) in 10, colon cancer in 3, cervical cancer in 3, renal cell carcinoma in 2, post transplant lymphoproliferative disorder (PTLD) in 2, head and neck cancer in 2, bladder cancer in 1 and vulvar cancer in 1. 83% of those who developed malignancy were smokers while 67% of those who did not develop malignancy were smokers (Chi-square is 3.41, P>0.05). Patients who developed malignancy were older at time of transplantation (mean ± SD, 58.0±7.5 vs. 55.6±9.0 years; P= 0.04).

CONCLUSIONS: Malignancy is a common complication after lung transplantation, with skin cancer being the most common. Age at transplantation seems to be a risk factor for development of malignancy. Smoking as a risk factor did not reach statistical significance in the studied population.

CLINICAL IMPLICATIONS: Malignancy is a common complication after lung transplantation and physicians should always keep it in mind.

DISCLOSURE: The following authors have nothing to disclose: Raid Abu-awwad, Ammar Khanhour, Robert Chapman, Alan Betensley

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Henry Ford Hospital - Department of Internal Medicine, Detroit, MI

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