本邦の肺移植後悪性腫瘍の現況

抄録

The number of organ transplants in Japan is now increasing following revision of the brain death law in 2010. However, de novo malignancies after lung transplantations have become obstacles to long-term survival. The purpose of this study was to analyze the incidence of de novo malignancies after lung transplantations in Japan. A total of 179 cases were performed by seven institutions in Japan from 2001 to 2010, and de novo malignancies had occurred in 18 patients (10.1%). The most common tumors were lymphoproliferative malignancies (12 cases, including 1 double de novo cancer), following cervical cancer (4 cases), breast cancer (2 cases), and tongue cancer (1 case). The mean time of occurrence after transplantation was 37.8 months (range 4 to 148). Reduction and/or withdrawal of immunosuppressions were seen in 14 cases. The 5-year survival of lymphoproliferative malignancies was not significantly different from other malignancies (47.6% and 62.5%, respectively, p=0.33). Death resulting from cancer occurred in 6 cases. This is the first nationwide survey of the incidence of various malignancies after lung transplantation in Japan. Further detailed surveys, follow-up, and establishment of screening algorithms for malignancies after lung transplantation in Japan are required to improve the rate of survival.