Orthotopic heart transplantation in patients with treated malignancies

The accumulated data suggest that carefully selected patients with a history of treated neoplasms and end-stage cardiac failure can expect satisfactory survival and little risk of recurrence and new-onset malignancy after transplantation. An optimal disease-free interval is difficult to estimate; the current experience suggests that it should be based on the histology and clinical stage of the disease at the time of diagnosis and treatment. The incidence of post-transplant infectious complications, rejection episodes, and coronary artery disease has been reported in only a few patients.6 Extreme caution must be exercised before transplantation is considered for patients with a history of clinically or histologically unfavorable tumors. Continued follow-up and further clinical experience is eagerly awaited to confirm these encouraging preliminary findings.