UNOS DonateLife

May 23, 2005

Association of Different Immunosuppressive Regimens with Posttransplant De Novo Malignancies in Liver Recipients

Authors: Wida S. Cherikh, Ph.D.*, H. Myron Kauffman, M.D.*, Brian D. Shames, M.D., Yulin Cheng, Ph.D.*, Douglas W. Hanto, M.D.

Seattle, Wash. -- A study examined the impact of maintenance immunosuppression regimens and association of induction therapy with de novo malignancies in liver transplant recipients. This study, among others, was presented at the American Transplant Congress, a combined scientific session of the American Society of Transplant Surgeons and the American Society of Transplantation, held at the Washington State Convention and Trade Center in Seattle, Wash. United Network for Organ Sharing staff researchers are indicated with an asterisk.

De novo malignancies are responsible for 22.1 percent of deaths in liver recipients surviving at least five years. And immunosuppression is a known risk factor for posttransplant de novo malignancies. An analysis was conducted on the development of any de novo malignancy in 18,404 primary deceased donor whole liver transplants during January 1, 1997 through December 31, 2002.

Induction therapy was found to have no significant effect on the risk of de novo cancer. The study concluded that the combination of tacrolimus and mycophenolate mofetil maintenance immunosuppression was associated with a significantly reduced risk of developing any malignancy and solid non-skin cancer. Tacrolimus alone was associated with a reduced risk of developing any cancer and skin cancer.

A private, nonprofit organization, UNOS manages the nation's organ transplant system and oversees the world's most comprehensive database of clinical transplant information under contract with the federal government. UNOS operates the 24-hour computerized organ sharing system, matching donated organs to patients registered on the national organ transplant waiting list. UNOS seeks to increase organ donation through education and improve transplant success rates through outcomes-based research and policymaking. The strength of the transplant database relies on the conscientious reporting of 412 UNOS member institutions.