Document Detail


Visceral Kaposi's sarcoma remission after intestinal transplant. First case report and systematic literature review.
MedLine Citation:
PMID:  20625354     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Kaposi's sarcoma (KS) is an infrequent vascular neoplasm commonly diagnosed as an isolated cutaneous lesion that can involve other organs. So far, there are no data in the literature about the development of KS after intestinal transplant. METHODS: In this study, the authors describe a case of "visceral KS" with pulmonary and intestinal involvement and perform a systematic literature review of case reports and single-center series identified in MEDLINE. RESULTS: This case was a 42-year-old man, diagnosed with visceral KS 9 months after receiving an isolated intestinal transplant. He was successfully treated with a combination of sirolimus and liposomal doxorubicin and achieved an 18-month disease-free survival. A total of 54 cases from 27 manuscripts and the present case were analyzed in this study. The mean time from transplant to diagnosis was 17.2 months. Lungs and gastrointestinal tract were the main organs involved. Immunosuppressants were discontinued in two of the three (66.7%) cases, and sirolimus was added in eight cases. Doxorubicin was used in 12 cases. In a univariate analysis, the use of Tacrolimus, type of transplant, and presence of cutaneous KS seem to be the significant predictors of response to therapy and survival; the addition of doxorubicin showed a reduction in graft loss. CONCLUSIONS: Treatment of KS in posttransplant patients should be designed aiming to obtain a complete response, irrespective of the organ affected. Only recipients who are able to achieve a sustained response would be able to obtain long-term disease-free survival.
Authors:
Francesco D'Amico; Claudia Fuxman; Fabio Nachman; Lisandro Bitetti; Martin Fauda; Constanza Echevarria; Hector Solar; Pedro Politi; Ana Cabanne; Eduardo Mauriño; Andres Ruf; Gabriel E Gondolesi
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Transplantation     Volume:  90     ISSN:  1534-6080     ISO Abbreviation:  Transplantation     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-03     Completed Date:  2010-10-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0132144     Medline TA:  Transplantation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  547-54     Citation Subset:  IM    
Affiliation:
Unidad de Hepatología, Cirugía Hepatobiliar y Transplante Hepático-Unidad de Nutrición, Rehabilitación y Transplante Intestinal, Hospital Universitario Fundacion Favaloro, Buenos Aires, Argentina.
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MeSH Terms
Descriptor/Qualifier:
Adult
Antibiotics, Antineoplastic / therapeutic use
Disease-Free Survival
Doxorubicin / therapeutic use
Humans
Immunosuppressive Agents / therapeutic use
Intestines / transplantation*
Male
Recurrence
Sarcoma, Kaposi / surgery*
Sirolimus / therapeutic use
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antibiotics, Antineoplastic; 0/Immunosuppressive Agents; 23214-92-8/Doxorubicin; 53123-88-9/Sirolimus

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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