Incidence and predictors of malignancy after heart transplantation: A UNOS registry analysis

Results from an analysis of the United Network for Organ Sharing (UNOS) registry, evaluating the incidence and risk factors for de novo malignancy after heart transplantation (N = 50,370), were published in the American Heart Journal by Magod et al. 

Key data: The 10-year incidence of de novo post-transplant malignancy was 20.6%. In multivariable analysis, increased odds of de novo malignancy were associated with older age (odds ratio [OR], 1.05; 95% confidence interval [CI], 1.05–1.06), male sex (female vs male; OR, 0.63; 95% CI, 0.58–0.68), and history of cigarette use (OR, 1.19; 95% CI, 1.11–1.28). Additional risk factors included induction immunosuppression with muromonab‑CD3 (OR, 1.47; 95% CI, 1.23–1.76) or use of >1 induction agent (OR, 1.44; 95% CI, 1.14–1.82), as well as hospitalization for infection (OR, 1.25; 95% CI, 1.18–1.33).

Key learning: De novo malignancy is a common long-term complication after heart transplantation and is associated with multiple clinical and treatment-related risk factors, supporting the need for risk-adapted cancer surveillance and prevention strategies.