Occurrence of cancers in immunosuppressed organ transplant recipients.

The findings in this study emphasize the need for lifetime follow-up of organ transplant recipients. Although a high percentage of posttransplant tumors are low-grade malignancies that are readily amenable to treatment, cancer has become a major cause of death in patients otherwise successfully treated by transplantation (6). An Australasian study of the causes of death of patients who survived for at least 10 years with a functioning renal allograft compared to those on dialysis for at least 10 years without transplantation, or with a failed transplant, showed that the proportions of deaths caused by cancer were 26%, 1%, and 3%, respectively. Nonetheless, the future holds promise. Attempts are being made to modify the present blunderbuss attack on the immune system with more specific methods of control. Much work is currently being done to induce states of immune unresponsiveness directed specifically, and only, at the foreign antigens of the allograft. Hopefully these efforts will eliminate the need for long term or intense immunosuppressive therapy and the problem of posttransplant malignancies will be relegated to a footnote in the history of organ transplantation.