Proliferation signal inhibitors and post-transplant malignancies in heart transplantation: practical clinical management questions.
Clin Transplant
; 25(5): E475-86, 2011.
Article
in En
| MEDLINE
| ID: mdl-21592231
ABSTRACT
Although malignancy is a major threat to long-term survival of heart transplant (HT) recipients, clear strategies to manage immunosuppression in these patients are lacking. Several lines of evidences support the hypothesis of an anticancer effect of proliferation signal inhibitors (PSIs mammalian target of rapamycin [mTOR] inhibitors) in HT recipients. This property may arise from PSI's ability to replace immunosuppressive therapies that promote cancer progression, such as calcineurin inhibitors or azathioprine, and/or through their direct biological actions in preventing tumor development and progression. Given the lack of randomized studies specifically exploring these issues in the transplant setting, a collaborative group reviewed current literature and personal clinical experience to reach a consensus aimed to provide practical guidance for the clinical conduct in HT recipients with malignancy, or at high risk of malignancy, with a special focus on advice relevant to potential role of PSIs.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Postoperative Complications
/
Heart Transplantation
/
Cell Proliferation
/
Heart Diseases
/
Immunosuppressive Agents
/
Neoplasms
Type of study:
Clinical_trials
/
Guideline
Limits:
Humans
Language:
En
Journal:
Clin Transplant
Journal subject:
TRANSPLANTE
Year:
2011
Document type:
Article
Affiliation country: