Themes in Literature Related to Incidence, Risk, and Prevention of Cancer in Solid-Organ Transplantation Recipients on Immunosuppressive Therapy.

BACKGROUND: Solid-organ transplants provide a second chance to thousands of critically ill patients with end-organ failure each year. Immunosuppressants are administered to patients to prevent graft rejection of a transplanted organ, such as a heart, kidney, or liver, while placing the recipient at greater risk for infection and cancer.

OBJECTIVE: The literature provides evidence of various cancers that have been found to develop in patients' posttransplantation. The purpose of this comprehensive review is to investigate the incidence, risk, and prevention of cancer in solid-organ transplantation recipients on immunosuppressive therapy.

METHODS: Google Scholar, Cumulative Index to Nursing and Allied Health Literature and Ovid databases were searched to identify research articles in peer-reviewed journals from 2011 to 2016. Variables under examination included cancer risk, cancer type, incidence, demographic characteristics, prevention, screening modalities, and education tools.

RESULTS: Six articles met the inclusion criteria. Results indicate that malignancy is a prominent postoperative finding in at least 4% to 5% of solid-organ transplant recipients, with evidence of various cancer types. Risk factors include male sex, increased age, number of years posttransplant, fair skin, white race, and UV exposure. Screening intervals and educational tools have been found to increase awareness and target those at greater risk.

CONCLUSION: Skin cancer and non-Hodgkin lymphoma were the most commonly diagnosed cancers in transplant recipients.

IMPLICATIONS FOR PRACTICE: Practitioners may find utility in screening tools, self-examination education for patients, and follow-up protocols to prevent further complications in this patient population. Early detection of cancer and those at risk may help decrease morbidity and mortality rates in organ recipients.