Current status and future prospective on malignancy after heart transplantation in Japan

Abstract

A nationwide survey on the incidence of variable malignancy after heart transplantation has been undertaken in Japan. This study included 83 patients (60 men, 23 women) who underwent heart transplantation in the 10-year period from January 2001 to December 2010 at heart transplantation centers in Japan. Patients were a mean age of 37 years at transplantation. Of these, 5 developed malignancy at the mean follow-up period of 5 years and 9 months (range: from 1 year and 6 months to 8 years and 9 months). Diagnoses of malignancy included malignant lymphoma in 3, colon cancer in 1, and urinary bladder cancer in 1. Some of the symptoms that triggered diagnoses were lymphadenopathy, fever, and lumbago. Incidental diagnoses of urinary bladder cancer were made during radiological examinations for gynecological disease. All 5 patients had been kept on triple immunosuppressant therapy and had experienced either no rejection or a single episode of one. A patient with malignant lymphoma deceased two years after the diagnosis, whereas the remaining 4 patients have survived as of the date of survey. This study carries considerable limitation that the number of heart recipients during the study period consisted of nearly half of the total heart transplant cases by the year 2014. Further studies are warranted to enhance the establishment of a guideline for optimal management of long-term survivors after heart transplant patients in view of prevention and an early diagnosis of malignancy.