Case Report
Copyright ©The Author(s) 2022.
World J Gastroenterol. Sep 14, 2022; 28(34): 5076-5085
Published online Sep 14, 2022. doi: 10.3748/wjg.v28.i34.5076
Table 1 Characteristics of 16 transplanted patients with gastrointestinal stromal tumors

Overall number

Male sex, n (%)1611 (69)
Age (yr), median (min; max)1659.5 (23; 74)
Type of organ transplantation, n (%)16
Kidney12 (75)
Liver4 (25)
Location of primitive tumor, n (%) 16
Stomach9 (56)
Small bowel3 (19)
Colon1 (6)
Other: pelvis, perineum, mesentery3 (19)
Time from transplantation to diagnosis (mo), median (min; max)1632 (5; 252)
Metastatic dissemination at diagnosis, n (%)160 (0)
Tumor size (mm), median (min; max)1545 (10; 230)
Risk of progression according to Joensuu’s criteria, n (%)14
Very low2 (14)
Low4 (29)
Intermediate2 (14)
High6 (43)
Surgical treatment, n (%) 1615 (94)
Adjuvant treatment, n (%)163 (19)
Modification of immunosuppression, n (%)119 (82)
Death during follow-up, n (%) 144 (29)
Table 2 Clinical features and immunosuppression regimen of 16 transplant patients with gastrointestinal stromal tumor
Age (yr)/sex
Transplanted organ
Time from transplantation to diagnosis
Location of primitive GIST
Metastasis at diagnosis
Immunosuppression before diagnosis
Immunosuppression after diagnosis
Agaimy and Wünsch[11]59/FKidney40 moStomachNoRelapse 68 moNot describedNot described
Agaimy and Wünsch[11]58/FKidney96 moSmall bowelNoNot describedNot describedNot described
Saidi et al[19]54/MLiver11 moColonNoNot describedTac, AzaNot described
Camargo et al[22]64/MLiver7 moPerineumNoNot describedTac, mycophenolate sodiumNot described
Tu et al[18]57/FKidney6 moPelvisNoNot describedSteroids, CsA, MMFCsA and MMF at half dosage; rapamycin-containing regimensteroids withdrawn
Mulder et al[12]72/MKidney21 yrStomachNoPeritoneal metastasis/24 moSteroids, CsASteroids, CsA (60% reduction in dosage)
Mrzljak et al[20]53/MLiver12 moJejunumNoNoTac, MMFSame
Cimen et al[13]46/FKidney18 yrStomachNoNot describedSteroids, CsA, AzaSame with reduced dosage of CsA
Cheung et al[14]64/MKidney2 yrStomachNoYes/2 yrSteroids, Tac, MMFSteroids, Tac (reduced dosage), everolimus
Cheung et al[14]48/MKidney1 yrMesenteryMultiple tumorsNoCsA, MMFCsA withdrawal, sirolimus introduction
Patiño et al[15]23/FKidney13 yrStomachNoLocal relapse/3 yrSteroids, Tac, MMFNot described
Xie et al[21]60/MLiver11 moStomachNoNoTac, sirolimus, MMFSame
Elkabets et al[17]74/MKidney7 yrStomachNoNoSteroids, CsA, MMFSwitch CsA to mTOR inhibitor
Takahashi et al[16]64/MKidney72 moSmall bowelNoNoSteroids, CsA, MMFStop CsA
Stammler et al60/MKidney5 moStomachNoNoSteroids, Tac, MMFSwitch MMF to belatacept
Stammler et al64/MKidney51 moStomachNoYes/23 moSteroids, CsA, MMFSwitch CsA to Tac
Table 3 Histopathological features, treatments, and outcome of 16 transplant patients with gastrointestinal stromal tumor
Size (mm)
Mitotic count
Fletcher’s criteria
Joensuu’s criteria
Mutation identified
Initial adjuvant treatment
Second line treatment
Agaimy and Wünsch[11]35< 5/50LowLowNot describedYesNoNot describedAlive and relapse free at 68 mo
Agaimy and Wünsch[11]23014/50HighHighNot describedYesNoNot describedNot described
Saidi et al[19]251/50LowHighNot describedYesNoNot describedAlive and relapse free at 18 mo
Camargo et al[22]505/50IntermediateHighNot describedYesNoNot describedAlive and relapse free at 20 mo
Tu et al[18]452-3/50LowLowPDGFRA exon 18 V824VYesNoNot describedAlive and relapse free 24 mo
Mulder et al[12]50> 10/50HighHighNot describedYesNoImatinib 400 mg/d then 200 mg/dDied 44 mo
Mrzljak et al[20]101/50Very lowVery lowNot describedYesNoNoDied 3 yr after from acute leukemia
Cimen et al[13]15014/50HighHighKIT T574delYesImatinib 400 mg/dNot describedAlive and relapse free at 12 mo
Cheung et al[14]309/50IntermediateIntermediateNot describedYesNoNoDied from pneumonia at 2 yr
Cheung et al[14]Not describedNot describedNot describedNot describedNot describedNoImatinib 400 mg/d for 1 yrSwitch CsA to sirolimusAlive and relapse free at 10 yr
Patiño et al[15]58Not describedIntermediate or highIntermediate of highNot describedYesNoImatinib 400 mg/dAlive and relapse free/5 yr after imatinib initiation
Xie et al[21]10< 5/50Very lowVery lowKIT exon 11 YesNoNoNot described
Elkabets et al[17]31Not describedNot describedNot describedNot describedYesNoNoAlive and relapse free at 40 mo
Takahashi et al[16]11020/50HighHighKIT exon 11YesImatinib 400 mg/d reduced to 3000 mg/dNoAlive and relapse free at 18 mo
Stammler et al272/5LowLowKIT exon 11YesNoNoAlive and relapse free at 2 mo
Stammler et al5110/50HighHighPDGFRA exon 18YesNoSunitinib then regorafenib then dasatinibDied 56 mo later