A review of nationwide population study of organ transplantation in Taiwan

Solid organ transplantation has become the therapy of choice for patients with end-stage organ disease. The frequently transplanted organs in Taiwan include liver, kidney, heart, and lung, and the success rate has improved significantly worldwide for the past decades. However, organ recipients are known to be at a higher risk of post-transplant infections and de novo cancer due to immunosuppression and oncogenic viral infections. Organ recipients are known to be at a two- to fourfold increased risk of cancer and the risks are particularly high for malignancies caused by viral infections, including post-transplant lymphoproliferative disorders via Epstein-Barr virus, Kaposi sarcoma via Kaposi sarcoma herpesvirus, anogenital cancers via human papillomavirus, and hepatocellular carcinoma via hepatitis B and C virus. Population-based cohort studies may help better understand the pattern of infection and cancer risk in transplant recipients and clarify the role of the immune system, infection, and risk factors in the development of malignancy. Improvement of surgical techniques, advancement of immunosuppressant therapy in addition to early detection and prevention of infection, and regular surveillance of de novo cancer after transplantation have become the mainstay of successful organ transplantation.