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Development of malignancy following solid organ transplantation

Daniel C Brennan, MD, FACP
Richard J Rodeheffer, MD
Richard F Ambinder, MD, PhD
Section Editor
Barbara Murphy, MB, BAO, BCh, FRCPI
Deputy Editors
Albert Q Lam, MD
Michael E Ross, MD


The chronic use of immunosuppressive agents to prevent allograft rejection increases the long-term risk of malignancy compared with that of the general population. This topic will review the general issue of malignancy following solid organ transplantation. The problems of second malignancies following bone marrow transplantation and the development of lymphoproliferative disorders following solid organ transplantation are discussed separately. (See "Malignancy after hematopoietic cell transplantation" and "Treatment and prevention of post-transplant lymphoproliferative disorders".)


There is an increased risk of a wide range of cancers associated with solid organ transplantation. The most extensive data come from a cohort study that analyzed the frequency of malignancy in over 175,000 solid organ transplant recipients during the period 1987 to 2008 [1]. The most common organs transplanted included kidney, liver, heart, and lung (in 58, 22, 10, and 4 percent of cases, respectively).

Overall, malignancy was identified in over 10,656 cases, which correlated with a standardized incidence ratio (SIR) of 2.10 (95% CI 2.06-2.14) compared with the general population and an excess absolute risk (EAR) of 719 cases per 100,000 person-years.

A significantly increased risk of malignancy was associated with more than 30 different primary sites. The tumor sites with a fivefold or greater increase, compared with the general population, included the following:

Kaposi sarcoma (KS; SIR 61 and EAR 15)

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Literature review current through: Nov 2017. | This topic last updated: May 09, 2016.
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