Abstract
Introduction: An increased risk of malignancy post-lung transplant (LTx) is established as a complication related to reduced immunosurveillance and patient demographics.
Aims: To identify the incidence, risk factors and clinical characteristics of solid-organ malignancy following LTx at The Irish National Lung Transplant Centre.
Methods: A retrospective single centre review of all 216 patients transplanted between 2005-2017. Data collected included patient demographics, transplant indication, surgery, smoking status, histological sub-type, TNM staging and outcomes.
Results: Nineteen patients were diagnosed with a solid-organ malignancy following LTx during follow-up (8.8%). The median time interval between transplant and cancer diagnosis was 32 months (range 12-133 months). Age at the time of transplant was significantly higher in those who subsequently developed malignancy (p=0.028, mean 58.3 v 49.7 years). Single LTx recipients appear at higher risk compared to double LTx recipients (OR 3.17, 95% CI 1.10-9.14). No single indication for LTx was identified as an independent risk factor.
Bronchogenic carcinoma was the most common malignancy (n=11, 5.1%); the majority were identified in the native lung of single transplant recipients (9 of 11). 82% were ex-smokers. Squamous cell carcinoma was the most common subtype (n=5). Five patients were stage IV at diagnosis with an overall 1-year mortality of 82%.
Conclusions: Bronchogenic carcinoma is the most common solid organ malignancy post LTx and has a high mortality. Risk factors include older age and single LTx. Despite close prospective monitoring, early detection remains challenging and adequate adequate screening guidelines post-transplant are currently lacking.
Footnotes
Cite this article as: European Respiratory Journal 2019; 54: Suppl. 63, PA1109.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2019