{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T16:52:28Z","timestamp":1769273548562,"version":"3.49.0"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2023,10,1]],"date-time":"2023-10-01T00:00:00Z","timestamp":1696118400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Barnes-Jewish Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,10,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>Malignancy is the leading cause of late mortality after orthotopic heart transplantation (OHT), and the burden of post-transplantation cancer is expected to rise in proportion to increased case volume following the 2018 heart allocation score change. In this report, we evaluated factors associated with de novo malignancy after OHT with a focus on skin and solid organ cancers.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Patients who underwent OHT at our institution between 1999 and 2018 were retrospectively reviewed (n\u2009=\u2009488). Terminal outcomes of death and development of skin and\/or solid organ malignancy were assessed as competing risks. Fine\u2013Gray subdistribution hazards regression was used to evaluate the association between perioperative patient and donor characteristics and late-term malignancy outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>By 1, 5 and 10 years, an estimated 2%, 17% and 27% of patients developed skin malignancy, while 1%, 5% and 12% of patients developed solid organ malignancy. On multivariable Fine\u2013Gray regression, age [1.05 (1.03\u20131.08); P\u2009&amp;lt;\u20090.001], government payer insurance [1.77 (1.20\u20132.59); P\u2009=\u20090.006], family history of malignancy [1.66 (1.15\u20132.38); P\u2009=\u20090.007] and metformin use [1.73 (1.15\u20132.59); P\u2009=\u20090.008] were associated with increased risk of melanoma and basal or squamous cell carcinoma. Age [1.08 (1.04\u20131.12); P\u2009&amp;lt;\u20090.001] and family history of malignancy [2.55 (1.43\u20134.56); P\u2009=\u20090.002] were associated with an increased risk of solid organ cancer, most commonly prostate and lung cancer.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Vigilant cancer and immunosuppression surveillance is warranted in OHT recipients at late-term follow-up. The cumulative incidence of skin and solid organ malignancies increases temporally after transplantation, and key risk factors for the development of post-OHT malignancy warrant identification and routine monitoring.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezad341","type":"journal-article","created":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T15:30:08Z","timestamp":1696951808000},"source":"Crossref","is-referenced-by-count":5,"title":["Characterization of <i>de novo<\/i> malignancy after orthotopic heart transplantation: single-centre outcomes over 20 years"],"prefix":"10.1093","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9909-8786","authenticated-orcid":false,"given":"Nadia H","family":"Bakir","sequence":"first","affiliation":[{"name":"Department of Surgery, Division of Cardiothoracic Surgery, Washington University School of Medicine, Barnes-Jewish Hospital , St. Louis, MO, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ioana B","family":"Florea","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Cardiothoracic Surgery, Washington University School of Medicine, Barnes-Jewish Hospital , St. Louis, MO, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jordan","family":"Phillipps","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Dermatology, Washington University School of Medicine, Barnes-Jewish Hospital , St. Louis, MO, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joel D","family":"Schilling","sequence":"additional","affiliation":[{"name":"Department of Medicine, Cardiovascular Division, Washington University School of Medicine, Barnes-Jewish Hospital , St. Louis, MO, USA"},{"name":"Department of Pathology and Immunology, Washington University School of Medicine, Barnes-Jewish Hospital , St. Louis, MO, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marci S","family":"Damiano","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Cardiothoracic Surgery, Washington University School of Medicine, Barnes-Jewish Hospital , St. Louis, MO, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6213-5758","authenticated-orcid":false,"given":"Gregory A","family":"Ewald","sequence":"additional","affiliation":[{"name":"Department of Medicine, Cardiovascular Division, Washington University School of Medicine, Barnes-Jewish Hospital , St. Louis, MO, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kunal D","family":"Kotkar","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Cardiothoracic Surgery, Washington University School of Medicine, Barnes-Jewish Hospital , St. Louis, MO, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akinobu","family":"Itoh","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Cardiothoracic Surgery, Washington University School of Medicine, Barnes-Jewish Hospital , St. Louis, MO, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr","given":"Ralph J","family":"Damiano","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Cardiothoracic Surgery, Washington University School of Medicine, Barnes-Jewish Hospital , St. Louis, MO, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc R","family":"Moon","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Cardiothoracic Surgery, Washington University School of Medicine, Barnes-Jewish Hospital , St. Louis, MO, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muhammad F","family":"Masood","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Cardiothoracic Surgery, Washington University School of Medicine, Barnes-Jewish Hospital , St. Louis, MO, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,10,10]]},"reference":[{"key":"2023102600461887500_ezad341-B1","doi-asserted-by":"crossref","first-page":"e137","DOI":"10.1161\/CIR.0000000000000509","article-title":"2017 ACC\/AHA\/HFSA focused update of the 2013 ACCF\/AHA Guideline for the management of heart failure: a report of the American College of Cardiology\/American Heart Association Task Force on clinical practice guidelines and the Heart Failure Society of America","volume":"136","author":"Yancy","year":"2017","journal-title":"Circulation"},{"key":"2023102600461887500_ezad341-B2","first-page":"e38","article-title":"Heart disease and stroke statistics\u20142016 update: a report from the American Heart 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