Remains of lung cancer after lung transplantation

Cystic fibrosis, one patient died of lung cancer two years after taking a lung transplant from a female smoker. This hypothesis raises the question of graft testing for transplantation.

It is a team from the Montpellier University Hospital which reports this rare and dramatic case in the magazine Lung cancer and highlighted in the blog "Biomedical realities"by Marc Gozlan at LeMonde.

Lung cancer after transplantation

A 39-year-old patient died of lung cancer after transplantation in 2017. The transplanted lungs were obtained from a 57-year-old smoker who had smoked the corresponding cigarette pack for about 30 years. years.

How could a cancerous graft transplant to a patient? In France, the various examinations generally allow, in addition to compatibility, the risk of infections, pathologies or cancer that would be reversing the transplantation. In this case, procedures were followed and CT showed no abnormalities in the lungs. The risk of undetectable cancer cells in the graft is extremely low, but this risk remains possible.

A dazzling cancer

When the patient was admitted to the oncology department, the imaging tests showed that many suspected foci, biopsy and DNA analysis confirmed the diagnosis of lung cancer commonly associated with smoking. A posteriori, scanners were analyzed one year after the graft revealing abnormal images. Rapidly, distant metastases (including skin lesions) occurred with a faster rate of cancer than normal. According to the authors, the accelerated growth of cancer may be due to the administration of immunosuppressive therapy.

Without questioning the benefits of transplants that save thousands of lives every year, the authors simply suggest that pulmonary transplants from active smokers should be carefully considered, especially because immunosuppressive therapy can promote the onset of cancer.

It was created on November 6, 2018

Sources:

Contemporary multiple non-small cell lung cancers in a recipient of allograft lung – Jean-Louis Pujol, Sandy Jean-Baptiste, Sebastien Bommart, Benoit Roch – Lung Cancer October 2018 Volume 124, Pages 291-292