Keep a Close Eye on Heart and Liver Transplant Patients

June 2010, Vol 1, No 2 - 2nd European Lung Cancer Conference

Geneva—Patients receiving heart and liver transplants are at greater risk of developing lung cancer, and physicians caring for these patients should screen for the disease in order to maximize the chance of detecting the malignancy early. These findings were reported at the 2nd European Lung Cancer Conference, and were described as the largest study to date looking at the development of lung cancer in transplant recipients.

The study was coordinated by Julien Mazieres, MD, PhD, of Hopital Larrey, Toulouse, France, and followed a group of 2831 patients who received organ transplants at Toulouse Hospital between February 1984 and September 2006. Overall, 0.85% of them developed lung cancer after transplant.

Dr Mazieres elaborated on these findings, saying, “We observed that 10 lung cancers occurred after kidney transplantation (0.5%), 8 after liver transplantation (1.3%), and 6 after heart transplantation (2.8%). This difference is statistically significant.” As to why the higher number of lung cancers in heart and liver transplant recipients, Dr Mazieres speculated that it “may be because more of these patients have a heavy smoking history compared to kidney transplant recipients.” The average number of packs per year was 75.2 for heart transplant patients, 40 for liver transplant recipients, and 28.5 for kidney transplant recipients.

It has long been known that the immunosuppressive drugs given to transplant patients increase their risk of developing new cancers, commonly cancers of the lips and skin, lymphoproliferative disorders, and Kaposi’s sarcoma.

By knowing what to expect, physicians should screen patients for cancers for which early detection and treatment is associated with a better prognosis, particularly skin cancers, the authors say. Doctors should also consider screening for lung cancer. “We can reasonably think that a close follow-up including chest examination and x-ray is easy to do and useful,” Dr Mazieres said. “At least, physicians taking care of transplant recipients should have in mind the increased risk of cancer and integrate this risk factor in their follow-up to improve the survival of these patients.”