Post-transplant Malignancy: An Overview and Review of Literatures

Main Article Content

Wael Lateef Jebur*

Abstract

Post-transplant malignancy is one of the contentious and feared consequences of Solid Organ Transplantation (SOT), which might detrimentally alter the outcome of transplantation. Risk factors are manifold, principally related to a suppressed immune system with intercurrent immunosuppressant medications commonly used in the context of SOT. Opportunistic viral infections encountered in SOT are crucial promoters of mitogenic proliferation in several common tumors. Lastly, immune suppressant therapy might trigger mitogenic changes directly.


In this paper, we are discussing post-SOT malignancies, elaborating on the different phases of its pathogenesis, and elucidating on the different aspects that linger in its risk factors, preventive strategies, and management.

Article Details

Jebur, W. L. (2025). Post-transplant Malignancy: An Overview and Review of Literatures. Journal of Clinical Nephrology, 9(1), 001–008. https://doi.org/10.29328/journal.jcn.1001144
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Copyright (c) 2025 Jebur WL.

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Shen B, Cen Z, Tan M, Song C, Wu X, Wang J, Huang M. Current status of malignant tumors after organ transplantation. Biomed Res Int. 2022;2022:5852451. Available from: https://doi.org/10.1155/2022/5852451

Santarsieri A, Rudge JF, Amin I, Gelson W, Parmar J, Pettit S, et al. Incidence and outcomes of post-transplant lymphoproliferative disease after 5365 solid-organ transplants over 20 years at two UK transplant centres. Br J Haematol. 2022;197(3):310-319. Available from: https://doi.org/10.1111/bjh.18065

Shaw R, Haque AR, Luu T, O'Connor TE, Hamidi A, Fitzsimons J, et al. Multicenter analysis of immunosuppressive medications on the risk of malignancy following adult solid organ transplantation. Front Oncol. 2023;13:1146002. Available from: https://doi.org/10.3389/fonc.2023.1146002

Samant H, Vaitla P, Kothadia JP. Posttransplant lymphoproliferative disorders. 2023 Jul 10. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513249/

Ume AC, Pugh JM, Kemp MG, Williams CR. Calcineurin inhibitor (CNI)-associated skin cancers: new insights on exploring mechanisms by which CNIs downregulate DNA repair machinery. Photodermatol Photoimmunol Photomed. 2020;36(6):433-440. Available from: https://doi.org/10.1111/phpp.12600

Rodríguez-Perálvarez M, Colmenero J, González A, Gastaca M, Curell A, Caballero-Marcos A, et al. Cumulative exposure to tacrolimus and incidence of cancer after liver transplantation. Am J Transplant. 2022;22(6):1671-1682. Available from: https://doi.org/10.1111/ajt.17021

Yusuf S, Bheemreddy H, Ahmed I, Krishnan N. Mycophenolate mofetil and the incidence of skin cancer in kidney transplant recipients. Transplantation. 2020;104(S3):S603. Available from: https://journals.lww.com/transplantjournal/fulltext/2020/09003/MYCOPHENOLATE_MOFETIL_AND_THE_INCIDENCE_OF_SKIN.899.aspx

Manickavasagar R, Thuraisingham R. Post-renal-transplant malignancy surveillance. Clin Med. 2020;20:142-145. Available from: http://dx.doi.org/10.7861/clinmed.2019-0423

Agrawal A, Ison MG, Danziger-Isakov L. Long-term infectious complications of kidney transplantation. CJASN. 2022 Feb;17(2):286-295. Available from: https://doi.org/10.2215/cjn.15971020

El-Mallawany NK, Rouce RH. EBV and post-transplant lymphoproliferative disorder: a complex relationship. Hematology Am Soc Hematol Educ Program. 2024; (1):728–735. Available from: https://doi.org/10.1182/hematology.2024000583

Kinch A, Baecklund E, Molin D, Pauksens K, Sundström C, Tufveson G, et al. Prior antithymocyte globulin therapy and survival in post-transplant lymphoproliferative disorders. Acta Oncol. 2021 Apr;60:771-778. Available from: https://doi.org/10.1080/0284186x.2021.1904520

Naimo E, Zischke J, Schulz TF. Recent advances in developing treatments of Kaposi’s sarcoma herpesvirus-related diseases. Viruses. 2021;13(9):1797. Available from: https://doi.org/10.3390/v13091797

Cernova J, Goiriz R, Cutino-Moguel MT, Greenhall G, Riddell A, Thuraisingham R, et al. The rising incidence of post-transplant Kaposi sarcoma in organ transplant recipients in a single-center cohort: should we be routinely screening? Br J Dermatol. 2024;191:i140-i140. Available from: http://dx.doi.org/10.1093/bjd/ljae090.294

Mechner M, Liu J, Masterson L, Fenton TR. HPV-associated oropharyngeal cancer: epidemiology, molecular biology, and clinical management. Nat Rev Clin Oncol. 2022 May;19(5):306-327. Available from: https://doi.org/10.1038/s41571-022-00603-7

Hewavisenti RV, Arena J, Ahlenstiel CL, Sasson SC. Human papillomavirus in the setting of immunodeficiency: pathogenesis and the emergence of next-generation therapies to reduce the high associated cancer risk. Front Immunol. 2023;14:1112513. Available from: https://doi.org/10.3389/fimmu.2023.1112513

Sadowska-Klasa A, Özkök S, Xie H, Leisenring W, Zamora D, Seo S, et al. Late cytomegalovirus disease after hematopoietic cell transplantation: significance of novel transplantation techniques. Blood Adv. 2024;8(14):3639-3651. Available from: https://doi.org/10.1182/bloodadvances.2023012175

Pietropaolo V, Prezioso C, Moens U. Merkel cell polyomavirus and Merkel cell carcinoma. Cancers (Basel). 2020 Jul 3;12(7):1774. Available from: https://doi.org/10.3390/cancers12071774

Letto G, Gritti M, Pettinato G, Carcano G, Gasperina DD. Tumors after kidney transplantation: a population study. World J Surg Oncol. 2023 Jan;21:18. Available from: https://doi.org/10.1186/s12957-023-02892-3

Biswas N, Deen J, Teare H, Robertson I. Bone marrow transplant recipients and their compliance with sun-protection measures in Queensland, Australia. J Dermatol. 2020 Apr;47(4):430-434. Available from: https://doi.org/10.1111/1346-8138.15262

Sartò GV, Alfieri C, Cosmai L, Brigati E, Campise M, Regalia A, et al. Post-kidney transplant cancer: A real-world retrospective analysis from a single Italian center. Transpl Int. 2024 Aug;37:13220. Available from: https://doi.org/10.3389/ti.2024.13220

Meyer E. Safer HLA mismatch transplantation. Blood. 2020 Sep;136(13):1472–1474. Available from: https://doi.org/10.1182/blood.2020006922

Jung SW, Lee H, Cha JM. Risk of malignancy in kidney transplant recipients: a nationwide population-based cohort study. BMC Nephrol. 2022 Apr;23:160. Available from: https://doi.org/10.1186/s12882-022-02796-6

Khalid H, Fareed MM, Dandekar T, Shityakov S. Calcineurin and mTOR inhibitors in kidney transplantation: integrative metamodeling on transplant survival and kidney function. Int Urol Nephrol. 2023 Sep;56:1403–1414. Available from: https://doi.org/10.1007/s11255-023-03754-3

Manickavasagar R, Thuraisingham R. Post-renal-transplant malignancy surveillance. Clin Med. 2020 Mar;20:142-145. Available from: https://doi.org/10.7861/clinmed.2019-0423

Huo Z, Li C, Xu X, Ge F, Wang R, Wen Y, et al. Cancer risks in solid organ transplant recipients: results from a comprehensive analysis of 72 cohort studies. Oncoimmunology. 2020 Nov 29;9(1):1848068. Available from: https://doi.org/10.1080/2162402x.2020.1848068

Turshudzhyan A. Post-renal transplant malignancies: opportunities for prevention and early screening. Cancer Treat Res Commun. 2021;26:100283. Available from: https://doi.org/10.1016/j.ctarc.2020.100283

Yamada M, L'Huillier AG, Green M. A focused review of Epstein-Barr virus infections and PTLD in pediatric transplant recipients: guidance from the IPTA and ECIL guidelines. J Pediatr Infect Dis Soc. 2024 Feb 28;13(Supplement_1):S31-S38. Available from: https://doi.org/10.1093/jpids/piad097

Markouli M, Ullah F, Omar N, Apostolopoulou A, Dhillon P, Diamantopoulos P, et al. Recent advances in adult post-transplant lymphoproliferative disorder. Cancers. 2022 Dec;14(23):5949. Available from: https://doi.org/10.3390/cancers14235949

Şi̇mşek GÖ. Immunotherapy in the treatment of cancer: today and tomorrow. Curr Mol Bio Rep. 2024 May;10:54–64.

Titov A, Zmievskaya E, Ganeeva I, Valiullina A, Petukhov A, Rakhmatullina A, et al. Adoptive immunotherapy beyond CAR T-cells. Cancers (Basel). 2021;13(4):743. Available from: https://doi.org/10.3390/cancers13040743