October 07, 1993

Article at Reuters

All transplant patients face cancer – doctors

By Wilson da Silva

SYDNEY – Every patient who undergoes an organ transplant is likely to develop cancer within 30 years, Australian doctors said on Thursday, quoting medical data collated since 1963.

“Of all patients with a functioning transplant over 20 years, 60 percent develop some type of cancer, mostly skin cancer,” Professor Peter Morris, an Australian researcher at Britain’s Oxford University, told Reuters.

 “Thirty years after a transplant, 100 percent of the transplant recipients will have some kind of cancer,” he said from Melbourne.

Morris told medical scientists at a conference this week at Melbourne’s St Vincent’s Hospital that the drugs used to suppress the body’s immune system and prevent rejection of

the newly transplanted organ were the culprits.

The drugs needed to be taken continuously after a transplant, impairing the body’s ability to fight off diseases, Morris said.

“These people just don’t have the immune system to fight these infections off,” he said.

Dr Alex Disney, of the Australian and New Zealand Dialysis and Transplant Registry at Adelaide’s Queen Elizabeth Hospital, said the rate for most cancers in patients who had undergone transplants was triple the normal rate.

Scientists have long known that immunosuppressants raise the risk of transplant patients developing cancer, but the Australian figures – considered by researchers the world’s most comprehensive – show the incidence is much higher than thought.

National figures kept by the Adelaide registry show that 40 percent of transplant survivors developed skin cancers over a 20-year period.

Another 20 percent of the 6,400 registered transplant patients developed other forms of cancer such as lymphomas and lung, liver, stomach and pancreas cancer.

Morris said that, when extrapolated, the data showed the rate of skin cancer and other cancers rose in a straight line until there was 100 percent incidence of cancer in transplant patients by the 30th year.

Disney said most cases did not involve fatal cancers, although in the case of skin cancers, four out of 10 developed squamous cell cancer, a virulent type of tumour prone to spreading throughout the body and killing its host.

Scientists in Europe, Australia and the United States are working on ways to trick the body into accepting the transplanted tissue as its own.