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World J Transplant. Sep 18, 2024; 14(3): 95987
Published online Sep 18, 2024. doi: 10.5500/wjt.v14.i3.95987
Genitourinary tumors and liver transplantation: A comprehensive review
Vibor Sesa, Hrvoje Silovski, Nikolina Basic-Jukic, Iva Kosuta, Maja Sremac, Anna Mrzljak
Vibor Sesa, Maja Sremac, Anna Mrzljak, Department of Gastroenterology and Hepatology, University Hospital Center Zagreb, Zagreb 10000, Croatia
Hrvoje Silovski, Department of Hepatobiliary Surgery and Transplantation, University Hospital Center Zagreb, Zagreb 10000, Croatia
Nikolina Basic-Jukic, Anna Mrzljak, Department of Medicine, School of Medicine, Zagreb 10000, Croatia
Nikolina Basic-Jukic, Department of Nephrology, Arterial hypertension, Dialysis and Transplantation, University Hospital Center Zagreb, Zagreb 10000, Croatia
Iva Kosuta, Department of Intensive Care Medicine, University Hospital Center Zagreb, Zagreb 10000, Croatia
Author contributions: Sesa V and Mrzljak A contributed to the conception and design of the study; Silovski H, Basic-Jukic N, Kosuta I and Sremac M contributed to the acquisition of data; Sesa V drafted the article; Mrzljak A critically revised the manuscript; All authors have read and approved the final manuscript.
Conflict-of-interest statement: All authors have no conflicts of interest to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Vibor Sesa, MD, Doctor, Department of Gastroenterology and Hepatology, University Hospital Center Zagreb, Kišpatićeva 12, Zagreb 10000, Croatia. viborsesa1@gmail.com
Received: April 23, 2024
Revised: May 28, 2024
Accepted: June 18, 2024
Published online: September 18, 2024
Processing time: 98 Days and 11.3 Hours
Abstract

Liver transplantation is as a crucial therapeutic option for patients with end-stage liver disease, but the persistent organ shortage emphasizes a need to explore unconventional donor sources, including individuals with a history of malignancies. This review investigates the viability of liver donation from individuals with current or past genitourinary malignancies, focusing on renal, prostate and urinary bladder cancers. The rising incidence of urogenital malignancies among potential donors is thought to result from increasing donor age. Analysis of transmission risks reveals low rates of donor-derived cancer transmission, particularly for early-stage renal and prostate cancers. Recipients with a history of genitourinary malignancy pose complex challenges regarding post-transplant immunosuppression and cancer recurrence. Nonetheless, the evidence suggests acceptable outcomes can be achieved with careful patient selection and tailored management strategies. Recommendations for pre-transplant evaluation and post-transplant surveillance are discussed, highlighting the need for individualized approaches in this patient population. Further prospective studies are warranted to refine guidelines and optimize outcomes in liver transplantation for patients with genitourinary malignancies.

Keywords: Liver transplantation, Genitourinary malignancies, Donor-transmitted cancer, Malignancy recurrence, Immunosuppression

Core Tip: While concerns of cancer transmission and recurrence exist, the evidence suggests that carefully selected donors and recipients may benefit from transplantation. Despite the heightened risk of post-transplant malignancy due to immunosuppression, early-stage urogenital tumors may not preclude transplantation, offering a life-saving option for eligible patients.