INTRODUCTION: Kaposi's Sarcoma (KS) is a malignant neoplasm arising from endothelial cells. HHV8-infection represents a key pathogenic determinant for the development of KS. There are no standard criteria to treat KS in immunosuppressed-individuals. Six cases (2.1%) of KS occurred in our Center among 285-recipients who underwent liver transplantation (LT) between October 2000 and November 2006. METHODS: Patients were four males and two females. Mean age was 57 years (range 44-65). Indication for LT was ESLD associated/non-associated with hepatocellular carcinoma (HCC). The immunosuppressive regimen consisted of cyclosporine/tacrolimus associated with steroids or daclizumab. HHV8-detection was performed by the serological method before LT, and by polymerase chain reaction (PCR)-analysis after KS. RESULTS: One patient had HCV-related cirrhosis and coinfection from HIV, three had HBV-related cirrhosis, two of these with coexistent HCC. The last two patients had alcoholic-cirrhosis, one with coexistent HCC. Mean time from transplantation to KS was 6.2 months (range 3.8-8.8). Three patients were treated with doxorubicin and three with switch from calcineurin-inhibitors to sirolimus. Three patients expired after 11.5, 8.8, and 7.4 months from KS diagnosis. DISCUSSION: KS should be treated by a multidisciplinary approach to obtain an early diagnosis and best management. Effective treatment with immunosuppression reduction or switch to sirolimus is mandatory and can induce complete regression.

Introduction: Kaposi's Sarcoma (KS) is a malignant neoplasm arising from endothelial cells. HHV8-infection represents a key pathogenic determinant for the development of KS. There are no standard criteria to treat KS in immunosuppressed-individuals. Six cases (2.1%) of KS occurred in our Center among 285-recipients who underwent liver transplantation (LT) between October 2000 and November 2006. Methods: Patients were four males and two females. Mean age was 57 years (range 44-65). Indication for LT was ESLD associated/non- associated with hepatocellular carcinoma (HCC). The immunosuppressive regimen consisted of cyclosporine/tacrolimus associated with steroids or daclizumab. HHV8-detection was performed by the serological method before LT, and by polymerase chain reaction (PCR)-analysis after KS. Results: One patient had HCV-related cirrhosis and coinfection from HIV, three had HBV-related cirrhosis, two of these with coexistent HCC. The last two patients had alcoholic-cirrhosis, one with coexistent HCC. Mean time from transplantation to KS was 6.2 months (range 3.8-8.8). Three patients were treated with doxorubicin and three with switch from calcineurin-inhibitors to sirolimus. Three patients expired after 11.5, 8.8, and 7.4 months from KS diagnosis. Discussion: KS should be treated by a multidisciplinary approach to obtain an early diagnosis and best management. Effective treatment with immunosuppression reduction or switch to sirolimus is mandatory and can induce complete regression. © 2007 Springer-Verlag.

Kaposi's sarcoma after liver transplantation / DI BENEDETTO, Fabrizio; Di Sandro, S; De Ruvo, N; Berretta, M; Masetti, Michele; Montalti, R; Ballarin, Roberto; Cocchi, S; Potenza, Leonardo; Luppi, Mario; Gerunda, Giorgio Enrico. - In: JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY. - ISSN 0171-5216. - STAMPA. - 134:6(2008), pp. 653-658. [10.1007/s00432-007-0329-3]

Kaposi's sarcoma after liver transplantation

DI BENEDETTO, Fabrizio;Di Sandro S;MASETTI, Michele;BALLARIN, Roberto;POTENZA, Leonardo;LUPPI, Mario;GERUNDA, Giorgio Enrico
2008

Abstract

Introduction: Kaposi's Sarcoma (KS) is a malignant neoplasm arising from endothelial cells. HHV8-infection represents a key pathogenic determinant for the development of KS. There are no standard criteria to treat KS in immunosuppressed-individuals. Six cases (2.1%) of KS occurred in our Center among 285-recipients who underwent liver transplantation (LT) between October 2000 and November 2006. Methods: Patients were four males and two females. Mean age was 57 years (range 44-65). Indication for LT was ESLD associated/non- associated with hepatocellular carcinoma (HCC). The immunosuppressive regimen consisted of cyclosporine/tacrolimus associated with steroids or daclizumab. HHV8-detection was performed by the serological method before LT, and by polymerase chain reaction (PCR)-analysis after KS. Results: One patient had HCV-related cirrhosis and coinfection from HIV, three had HBV-related cirrhosis, two of these with coexistent HCC. The last two patients had alcoholic-cirrhosis, one with coexistent HCC. Mean time from transplantation to KS was 6.2 months (range 3.8-8.8). Three patients were treated with doxorubicin and three with switch from calcineurin-inhibitors to sirolimus. Three patients expired after 11.5, 8.8, and 7.4 months from KS diagnosis. Discussion: KS should be treated by a multidisciplinary approach to obtain an early diagnosis and best management. Effective treatment with immunosuppression reduction or switch to sirolimus is mandatory and can induce complete regression. © 2007 Springer-Verlag.
2008
134
6
653
658
Kaposi's sarcoma after liver transplantation / DI BENEDETTO, Fabrizio; Di Sandro, S; De Ruvo, N; Berretta, M; Masetti, Michele; Montalti, R; Ballarin, Roberto; Cocchi, S; Potenza, Leonardo; Luppi, Mario; Gerunda, Giorgio Enrico. - In: JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY. - ISSN 0171-5216. - STAMPA. - 134:6(2008), pp. 653-658. [10.1007/s00432-007-0329-3]
DI BENEDETTO, Fabrizio; Di Sandro, S; De Ruvo, N; Berretta, M; Masetti, Michele; Montalti, R; Ballarin, Roberto; Cocchi, S; Potenza, Leonardo; Luppi, Mario; Gerunda, Giorgio Enrico
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