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- W4387473062 abstract "Malignancy is the leading cause of late mortality after orthotopic heart transplantation (OHT), and the burden of post-transplantation cancer is expected to rise in proportion to increased case volume following the 2018 heart allocation score change. In this report, we evaluated factors associated with de novo malignancy after OHT with a focus on skin and solid organ cancers.Patients who underwent OHT at our institution between 1999-2018 were retrospectively reviewed (n = 488). Terminal outcomes of death and development of skin and/or solid organ malignancy were assessed as competing risks. Fine-Gray subdistribution hazards regression was used to evaluate the association between perioperative patient and donor characteristics and late term malignancy outcomes.By one, five, and ten years, an estimated 2%, 17%, and 27% of patients developed skin malignancy, while 1%, 5%, and 12% of patients developed solid organ malignancy. On multivariable Fine-Gray regression, age (1.05 (1.03-1.08); P < 0.001), government payer insurance (1.77 (1.20-2.59); P = 0.006), family history of malignancy (1.66 (1.15-2.38); P = 0.007), and metformin use (1.73 (1.15-2.59); P = 0.008) were associated with increased risk of melanoma and basal or squamous cell carcinoma. Age (1.08 (1.04-1.12); P < 0.001) and family history of malignancy (2.55 (1.43-4.56); P = 0.002) were associated with an increased risk of solid organ cancer, most commonly prostate and lung cancer.Vigilant cancer and immunosuppression surveillance is warranted in OHT recipients at late term follow-up. The cumulative incidence of skin and solid organ malignancies increases temporally after transplantation, and key risk factors for development of post-OHT malignancy warrant identification and routine monitoring." @default.
- W4387473062 created "2023-10-11" @default.
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- W4387473062 date "2023-10-10" @default.
- W4387473062 modified "2023-10-17" @default.
- W4387473062 title "Characterization of De Novo Malignancy after Orthotopic Heart Transplantation: Single Center Outcomes Over Twenty Years" @default.
- W4387473062 doi "https://doi.org/10.1093/ejcts/ezad341" @default.
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- W4387473062 hasPublicationYear "2023" @default.
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