Cancer Surveillance in Solid Organ Transplant Recipients With a Pretransplant History of Malignancy: Multidisciplinary Collaborative Expert Opinion
Kymberly D. Watt, Stacey Rolak, David P. Foley, Jennifer K. Plichta, Sandhya Pruthi, Deborah Farr, Fiona O. Zwald, Richard D. Carvajal, Arkadiusz Z. Dudek, Cristina B. Sanger, Rocco Ricciardi, George J. Chang, Don S. Dizon, Carrie Langstraat, Deanna Teoh, Piyush K. Agarwal, Talal Al‐Qaoud, Scott E. Eggener, Cassie C. Kennedy, Jonathan D’Cunha, Nisha Mohindra, Shelby Stewart, Thomas Habermann, Stephen J. Schuster, Matthew A. Lunning, Nirav N. Shah, Morie A. Gertz, Jayesh Mehta, Attaya Suvannasankha, Elizabeth C. Verna, Maryjane Farr, Christopher D. Blosser, Laura L. Hammel, David Al‐Adra
Abstract
With improved medical treatments, the prognosis for many malignancies has improved, and more patients are presenting for transplant evaluation with a history of treated cancer. Solid organ transplant (SOT) recipients with a prior malignancy are at higher risk of posttransplant recurrence or de novo malignancy, and they may require a cancer surveillance program that is individualized to their specific needs. There is a dearth of literature on optimal surveillance strategies specific to SOT recipients. A working group of transplant physicians and cancer-specific specialists met to provide expert opinion recommendations on optimal cancer surveillance after transplantation for patients with a history of malignancy. Surveillance strategies provided are mainly based on general population recurrence risk data, immunosuppression effects, and limited transplant-specific data and should be considered expert opinion based on current knowledge. Prospective studies of cancer-specific surveillance models in SOT recipients should be supported to inform posttransplant management of this high-risk population.