泌尿生殖系统肿瘤与肝移植:全面回顾。

Vibor Sesa, Hrvoje Silovski, Nikolina Basic-Jukic, Iva Kosuta, Maja Sremac, Anna Mrzljak
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引用次数: 0

摘要

肝移植是终末期肝病患者的重要治疗选择,但器官持续短缺强调了探索非常规供体来源的必要性,包括有恶性肿瘤病史的个体。这篇综述探讨了从目前或过去患有泌尿生殖系统恶性肿瘤的个体捐献肝脏的可行性,重点关注肾癌、前列腺癌和膀胱癌。潜在捐献者中泌尿生殖系统恶性肿瘤发病率的上升被认为是捐献者年龄增加的结果。对传播风险的分析表明,供体衍生癌症的传播率较低,尤其是早期肾癌和前列腺癌。有泌尿生殖系统恶性肿瘤病史的受者在移植后免疫抑制和癌症复发方面面临着复杂的挑战。尽管如此,有证据表明,通过谨慎选择患者和量身定制的管理策略,可以获得可接受的结果。本文讨论了移植前评估和移植后监测的建议,强调了对这一患者群体采取个体化方法的必要性。有必要进一步开展前瞻性研究,以完善指南并优化泌尿生殖系统恶性肿瘤患者肝移植的疗效。
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Genitourinary tumors and liver transplantation: A comprehensive review.

Liver transplantation is as a crucial therapeutic option for patients with end-stage liver disease, but the persistent organ shortage emphasizes a need to explore unconventional donor sources, including individuals with a history of malignancies. This review investigates the viability of liver donation from individuals with current or past genitourinary malignancies, focusing on renal, prostate and urinary bladder cancers. The rising incidence of urogenital malignancies among potential donors is thought to result from increasing donor age. Analysis of transmission risks reveals low rates of donor-derived cancer transmission, particularly for early-stage renal and prostate cancers. Recipients with a history of genitourinary malignancy pose complex challenges regarding post-transplant immunosuppression and cancer recurrence. Nonetheless, the evidence suggests acceptable outcomes can be achieved with careful patient selection and tailored management strategies. Recommendations for pre-transplant evaluation and post-transplant surveillance are discussed, highlighting the need for individualized approaches in this patient population. Further prospective studies are warranted to refine guidelines and optimize outcomes in liver transplantation for patients with genitourinary malignancies.

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