Case Report
Volume 7 Issue 3 - 2020
Advanced Gastric Cancer after Two Liver and One Renal Transplantation. Case Report
Rinaldis A1, Bonini AL1, Matavelli FA1, Beron RI1, Lourenço LG2*
1Surgeon, General Surgery Division, Hospital do Rim, UNIFESP, Brazil
2Head of General Surgery Division, Hospital do Rim, UNIFESP, Brazil
*Corresponding Author: Lourenço LG, Head of General Surgery Division, Hospital do Rim, UNIFESP, Brazil.
Received: January 21, 2020; Published: February 26, 2020


Introduction: An estimated 20% increase of malignancy incidence has been found on liver and renal transplanted populations, probably associated with long-term use of immunosuppressant agents. Therapeutic approach for these patients was often treacherous and risky. Late detection of tumors and graft related complications was a common scenario. Nowadays the transplant recipients are able to receive multiple oncologic treatments. 

Case Report: A 69-year-old male was submitted to multiple organ transplantation surgeries being those, two liver and one renal transplantations on a 16 year period. The liver transplantations were in 1994 and 1999 due to HCV infection. He remained stable until 2005 when chronic uses of immunosuppressive drugs lead him to chronic renal failure and he received a deceased donor kidney graft in 2007. Two years later, after dyspeptic symptoms, initial investigation and workup was done with EGD and abdominal CT and a gastroesophageal junction adenocarcinoma was diagnosed. Surgical treatment was then performed with a limited lymphadenectomy due to adhesions. Pathology results were an IIIB stage stomach carcinoma. 

Discussion: Although the most common malignancies found among liver and renal transplanted populations are lymphoproliferative and skin tumors, there´s an increased incidence of gastric malignancies when compared to non-transplanted patients. The impact of overall medical costs related to malignancy in transplanted patients is high and close surveillance and early detection of such malignancies is important. 

Conclusion: Transplanted populations are at higher risk of developing neoplasm in different locations. An aggressive screening with early detection and treatment it´s crucial to avoid lethal outcomes.

Keywords: Transplant, Gastric Cancer, Immunotherapy


  1. Grulich AE., et al. “Incidence of cancers in people with HIV/AIDS compared with immunosuppressed transplant recipients: a meta-analysis”. Lancet 370.9581 (2007): 59-67. 
  2. Biggar RJ., et al. “Hodgkin Lymphoma and immunodeficiency in persons with HIV/AIDS”. Blood 108 (2006): 3786-3791.
  3. Grulich AE., et al. “Rates of non-AIDS-defining cancers in people with HIV infection before and after AIDS diagnosis”. AIDS 16 (2002): 1155-1161.
  4. Vajdic CM., et al. “Cancer incidence before and after kidney transplantation”. Journal of the American Medicine Association 296 (2006): 2823-2831.
  5. Villeneuve PJ., et al. “Cancer incidence among Canadian kidney transplant recipients”. American Journal of Transplantation 7 (2007): 941-948.
  6. Birkeland SA., et al. “Cancer risk in patients on dialysis and after renal transplantation”. Lancet 355 (2000): 1886-1887.
  7. Kyllonen L., et al. “Cancer incidence in a kidney-transplanted population”. Transplant International 13.1 (2000): S394-398.
  8. Peen I. “Cancer following cyclosporine therapy”. Transplantation 43 (1987): 32-35.
  9. Penn I. “Post-transplant malignancy: the role of immunosuppression”. Drug Safety 23 (2000): 101-113.
  10. Trofe J., et al. “The role immunosuppression in lymphoma”. Recent Results in Cancer Research 159 (2002): 55-56.
  11. Keay S., et al. “Posttransplant lymphoproliferative disorder associated with OKT3 and decreased antiviral prophylaxis in pancreas transplant recipients”. Clinical Infectious Diseases 26 (1998): 596-600.
  12. Meier-Kriesche HU., et al. “Association of antibody induction with short and long-term cause specific mortality in renal transplant recipients”. Journal of the American Society of Nephrology 13 (2002): 769-772.
  13. Buell JF., et al. “Incidental diagnosis of gastric cancer in transplant recipients improves patient survival”. Surgery 132.4 (2002): 754-760. 
  14. Kimura K. “Gastritis and gastric cancer”. Asian Gastroenterology Clinics of North America 30 (2000): 565-590.
  15. Adami J., et al. “Cancer risk following organ transplantation: a nationwide cohort study in Sweden”. British Journal of Cancer 89.7 (2003): 1221-1227. 
  16. Huang JQ., et al. “Meta-analysis of the relationship between Helicobacter pylori seropositivity and gastric cancer”. Gastroenterology 114 (1998): 1169-1179.
  17. Romero-Vargas ME., et al. “Cancers of new appearance in liver transplant recipients: incidence and evolution”. Transplantation Proceedings 38.8 (2006): 2508-2510.
  18. Kenngott S., et al. “Rapid development of esophageal squamous cell carcinoma after liver transplantation for alcohol-induced cirrhosis”. Transplant International 16.9 (2003): 639-41.
  19. Valero JM., et al. “De novo malignancies in liver transplantation”. Transplantation Proceedings 35.2 (2003): 709-711.
  20. Trotter JF and Brazer SR. “Rapid progression to high-grade dysplasia in Barrett’s esophagus after liver transplantation”. Liver Transplant Surgery 5.4 (1999): 332-332.
  21. Ilan Y., et al. “Esophageal malignancy after liver transplantation in patient with Barrett’s esophagus”. Scandinavian Journal of Gastroenterology 31.4 (1996): 415-416. 
  22. Díaz de Liaño A., et al. “Esophageal squamous cell carcinoma after liver transplantation”. Clinical and Translational Oncology 7.11 (2005): 518-520. 
  23. Yoshihiko H., et al. “Cancer risk after renal transplantation in Japan”. International Journal of Cancer 71 (1997): 517-520.
  24. Ochiai T., et al. “Development of malignancies in Japanese renal-transplant recipients”. Transplantation Proceedings 14 (1987): 2967-2970.
  25. Hung YM., et al. “De novo malignancies after kidney transplantation”. Urology 69.6 (2007): 1041-1044.
  26. Galve ML., et al. “Incidence and outcome of de novo malignancies after liver transplantation”. Transplantation Proceedings 31 (1999): 1275.
Citation: Lourenço LG.., et al. “Advanced Gastric Cancer after Two Liver and One Renal Transplantation. Case Report”. EC Gastroenterology and Digestive System 7.3 (2020): 01-05.

PubMed Indexed Article

EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005

EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777

EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347

EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478

EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253

EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033

EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992

EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505

EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793

EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211

EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047

EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560

EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318

EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819

EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840

EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344

EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476

EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658

EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489

EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278

EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108

EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571

EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333

EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883

EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001

EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937

EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723

EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726

EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603

EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646

EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616

EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290

EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226

EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812

EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268

News and Events

January Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the January issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for Upcoming Issue

ECronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before January 17, 2022.

Certificate of Publication

ECronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

ECronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.

Immediate Assistance

The prime motto of this team is to clarify all the queries without any delay or hesitation to avoid the inconvenience. For immediate assistance on your queries please don't hesitate to drop an email to