Abstract
Impact of Donor Cancer-Free Interval on Post-Transplant Malignancy After Lung Transplantation
The Journal of heart and lung transplantation, v 45(5), pp 506-506
Apr 2026
Abstract
Purpose: The use of donor lungs from individuals with prior malignancy remains controversial due to concern for transmission and post-transplant cancer risk. This study evaluated whether the donor cancer-free interval modifies the risk of post-transplant malignancy among lung transplant recipients.
Methods: The UNOS database was queried for adult recipients of isolated lung transplants performed between April 1994 and June 2025 using donors with a history of malignancy. The primary outcome was development of post-transplant malignancy. Cox proportional hazards regression identified predictors of post-transplant cancer, focusing on the donor’s cancer-free interval (time from completion of cancer treatment to organ procurement). Comparisons used chi-square or Fisher’s exact tests, as appropriate.
Results: Among 812 lung transplant recipients of donors with prior malignancy, 69 (8.5%) developed post-transplant cancer. Affected recipients were older (61 ± 9 vs. 57 ± 11 years, p=0.004) and more often male (72.5% vs. 58.6%, p=0.03). Donor age (46 ± 12 vs. 44 ± 11 years, p=0.29), cancer type (p=0.81), and cancer-free interval (12.1 ± 10.4 vs. 11.5 ± 9.6 years, p=0.56) were similar between groups. On multivariable analysis, recipient age (HR 1.04 per year, 95% CI 1.01-1.07, p=0.01) predicted post-transplant malignancy, while donor cancer-free interval showed no significant association.
Conclusion: Post-transplant malignancy among recipients of donor lungs with prior cancer is uncommon and not influenced by the donor’s cancer-free interval. These findings suggest that with careful donor selection and cancer history assessment, prior donor malignancy should not automatically preclude lung donation, potentially expanding the donor pool safely.
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Details
- Title
- Impact of Donor Cancer-Free Interval on Post-Transplant Malignancy After Lung Transplantation
- Creators
- M. Daniel - University of California, Los AngelesJ. Song - University of California, Los AngelesS. McKay - University of California, Los AngelesH. Zappacosta - University of California, Los AngelesP. Cho - Drexel UniversityJ. White - University of California, Los AngelesA. Abramov - University of California, Los AngelesD. Telesca - University of California, Los AngelesA. Ardehali - University of California, Los Angeles
- Publication Details
- The Journal of heart and lung transplantation, v 45(5), pp 506-506
- Conference
- 46th Annual Meeting and Scientific Sessions of the International Society for Heart and Lung Transplantation (ISHLT), 46th (Toronto, Ontario, Canada, 22 Apr 2026–26 Apr 2026)
- Publisher
- Elsevier Inc
- Number of pages
- 1
- Resource Type
- Abstract
- Language
- English
- Academic Unit
- College of Medicine
- Web of Science ID
- WOS:001761532600016
- Other Identifier
- 991022189167904721