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. 2021 Feb;21(2):475-483.
doi: 10.1111/ajt.16324. Epub 2020 Oct 10.

Preexisting melanoma and hematological malignancies, prognosis, and timing to solid organ transplantation: A consensus expert opinion statement

David P Al-Adra  1 , Laura Hammel  2 , John Roberts  3 , E Steve Woodle  4 , Deborah Levine  5 , Didier Mandelbrot  6 , Elizabeth Verna  7 , Jayme Locke  8 , Jonathan D'Cunha  9 , Maryjane Farr  7 , Deirdre Sawinski  10 , Piyush K Agarwal  11 , Jennifer Plichta  12 , Sandhya Pruthi  13 , Deborah Farr  14 , Richard Carvajal  7 , John Walker  15 , Fiona Zwald  16 , Thomas Habermann  17 , Morie Gertz  17 , Philip Bierman  18 , Don S Dizon  19 , Carrie Langstraat  20 , Talal Al-Qaoud  1 , Scott Eggener  11 , John P Richgels  11 , George J Chang  21 , Cristina Geltzeiler  1 , Gonzalo Sapisochin  22 , Rocco Ricciardi  23 , Alexander S Krupnick  24 , Cassie Kennedy  13 , Nisha Mohindra  25 , David P Foley  1 , Kymberly D Watt  13
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Preexisting melanoma and hematological malignancies, prognosis, and timing to solid organ transplantation: A consensus expert opinion statement

David P Al-Adra et al. Am J Transplant. 2021 Feb.

Abstract

Patients undergoing evaluation for solid organ transplantation (SOT) frequently have a history of malignancy. Only patients with treated cancer are considered for SOT but the benefits of transplantation need to be balanced against the risk of tumor recurrence, taking into consideration the potential effects of immunosuppression. Prior guidelines on timing to transplant in patients with a prior treated malignancy do not account for current staging, disease biology, or advances in cancer treatments. To update these recommendations, the American Society of Transplantation (AST) facilitated a consensus workshop to comprehensively review contemporary literature regarding cancer therapies, cancer stage specific prognosis, the kinetics of cancer recurrence, as well as the limited data on the effects of immunosuppression on cancer-specific outcomes. This document contains prognosis, treatment, and transplant recommendations for melanoma and hematological malignancies. Given the limited data regarding the risk of cancer recurrence in transplant recipients, the goal of the AST-sponsored conference and the consensus documents produced are to provide expert opinion recommendations that help in the evaluation of patients with a history of a pretransplant malignancy for transplant candidacy.

Keywords: cancer/malignancy/neoplasia; clinical research/practice; editorial/personal viewpoint; organ transplantation in general; patient safety; recipient selection.

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Figure 1.
AST Survey Results.
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