Transplant Oncology
A Frontier in Multidisciplinary Cancer Care
- 1st Edition - November 8, 2024
- Imprint: Academic Press
- Editor: Maen A. Abdelrahim
- Language: English
- Paperback ISBN:9 7 8 - 0 - 4 4 3 - 2 1 9 0 1 - 6
- eBook ISBN:9 7 8 - 0 - 4 4 3 - 2 1 9 0 2 - 3
**Selected for 2025 Doody’s Core Titles® in Transplantation Surgery**Transplant Oncology: A Frontier in Multidisciplinary Cancer Care summarizes new and evolving scientific finding… Read more
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Transplant Oncology: A Frontier in Multidisciplinary Cancer Care summarizes new and evolving scientific findings and discoveries in the field of cancer and transplants and gives guidance on future directions and related research. With a strong focus on transplant oncology, the book examines new and evolving topics, including the utilization of immunotherapy in special patient populations as well as the clinical updates on new concepts in the field such as using circulating tumor DNA (ctDNA) as a tool for minimal disease detection, surveillance, and treatment response evaluation as well as rejection assessment and detection in transplant patient for oncological indications.
Sections cover applications of transplant medicine and surgery in oncology to improve patient survival outcome and quality of life. The book gives insight into anticancer strategies, such as initiating studies in genomics and cancer immunogenomics based on new insights in liver cancer.
In addition, it describes how the adoption of surgical transplantation techniques in oncology has improved conventional resection and bridged the gap between tumor and transplant immunology. This is a must have reference for all those that want to be familiar and up-to-date with the dynamic changes in the field including practicing physicians, scientists, and trainees.
- Illustrates the concept and history of transplant oncology as an evolving field for the management of hepatocellular carcinoma
- Discusses the utility and safety of immunotherapy in the transplant setting
- Summarizes the utilization of immune checkpoint inhibitor therapies in pre-and post-liver transplants for HCC patients and discusses the assessment of immune checkpoint inhibitor regulators that might determine liver transplant outcomes
- Highlights new and evolving topics including the utilization of immunotherapy in special patient populations as well as the clinical updates on new concepts in the field, including treatment and rejection assessment
Practicing oncologists, hepatologists, immunologists, and surgeons both in the academic and private sectors as well as healthcare professionals who are members of cancer associations, cancer patient organizations, medical associations, Health decision-makers include the cabinet, health or deputy health ministers, parliamentarians, funding agencies, and community leaders
- Title of Book
- Cover image
- Title page
- Table of Contents
- Copyright
- Dedication
- List of contributors
- About the editor
- Foreword
- Foreword
- Foreword
- Preamble
- Preface
- Acknowledgments
- Introduction
- Transplant oncology
- Section I. Transplant oncology: An evolving field in cancer care
- Chapter 1. Transplant oncology: Concept, history, and evolution
- Inherent learning orientation gives to transplant oncology a competitive advantage over other therapeutic strategies
- Transplant oncology shares the same principles as surgical oncology
- Transplant oncology aims at substantial transplant benefit while preserving competitive patient survival. Tumor response to therapies is a major tool for patient selection
- Hepatocellular carcinoma
- Perihilar and intrahepatic cholangiocarcinoma (pCC and iCC)
- The concept of oncologic acuity should be incorporated in organ allocation and patients' priority systems
- Immunomanipulation and organ resuscitation offer opportunities to transplant oncology
- Conclusion and evolutionary landscape
- Chapter 2. Prehistory of transplant oncology era
- Evolution of liver transplantation and early experience in hepatobiliary malignancies
- Rise of transplant oncology: The “4E's”
- Future perspectives
- Abbreviations
- Section II. Transplantations for oncological indications
- Chapter 3. Hepatocellular carcinoma
- Pathophysiology and staging of HCC
- Diagnosis of HCC
- Staging of HCC
- Curative treatment
- Surgical resection
- Criteria for liver transplantation
- Approaches to liver transplantation
- Decreasing the drop out rate
- Downstaging and bridging therapy
- Immunosuppression after transplant
- Recurrence after transplantation
- Neoadjuvant therapies
- Conclusion
- Chapter 4. Cholangiocarcinoma and liver transplantation
- Introduction
- Treatment options for localized cholangiocarcinoma: A comprehensive overview
- Liver transplantation for peri-hilar cholangiocarcinoma
- Neoadjuvant chemoradiation therapy and survival outcomes
- Comparison with and without neoadjuvant therapy
- Selection criteria and neoadjuvant therapy
- Surgical technique and transplant procedure
- Post-transplant follow-up
- Living donor liver transplantation
- Discussion and conclusion
- Liver transplant for intrahepatic cholangiocarcinoma
- Lack of data on selection criteria and neoadjuvant therapy
- Expanding the role of liver transplantation in iCCA treatment
- Liver transplant criteria launched at Houston Methodist-MD Anderson Cancer Center
- Retrospective data analysis on transplant patients with iCCA
- Discussion and conclusion
- Liver transplantation for cholangiocarcinoma: From perihilar to intrahepatic
- Chapter 5. Transplantation for metastatic colorectal cancer to liver
- Introduction
- Evolution of LT for nCRLM
- Patient, donor, and graft selection
- Donor and graft selection
- Recipient outcomes
- Future directions and conclusion
- Chapter 6. Liver transplantation for neuroendocrine neoplasms liver metastases
- Introduction
- Primary neuro-endocrine tumor
- Metastatic liver disease
- NELM diagnosis
- NELM morphological pattern
- NELM treatment
- Liver transplantation for neuroendocrine liver metastases
- Rationale
- Results of liver transplantation for NELM
- Comparison between liver transplantation and other treatment modalities
- Specificities of liver transplantation for neuroendocrine liver metastases
- Recipient selection
- Milan criteria for LT for NELM
- European Neuroendocrine Tumor Society criteria (ENETS guidelines)
- UNOS guidelines (United Network for Organ Sharing)
- Pre-transplantation work-up
- Liver grafts and LT techniques
- Immunosuppression and rejection
- NENs metastases recurrence post liver transplantation
- Prognostic factors for oncological long-term outcomes
- Experience with LT for NELM at Cliniques Universitaires Saint Luc
- Conclusions and future directions
- Chapter 7. Hepatoblastoma
- Hepatoblastoma (diagnosis, stratification and treatment)
- Diagnosis
- Stratification
- Treatment
- Liver transplantation in hepatoblastoma
- Pre-operative
- Intra-operative
- Post-operative
- Long-term outcomes
- Section III. Transplant oncology and immunotherapy
- Chapter 8. Transplant oncology and immunotherapy: Immunotherapy and liver transplants
- Introduction
- ICPI pre-liver transplant: HCC bridging therapy
- ICPI post-liver transplant: HCC palliative therapy
- Assessment of immune checkpoint inhibitors
- Does immunosuppression affect the efficacy of ICPIs?
- Which ICPI class is safer?
- Can liver biopsy help with patient selection and prediction of rejection?
- Biomarkers for graft rejection
- Bone marrow mesenchymal stem cells on acute rejection of liver allografts in rats
- Liver enzymes
- Cytokines and other markers related to inflammation
- The timing of ICPI peri-transplant
- What about adverse events of ICPIs?
- Conclusions
- Chapter 9. B. Immunotherapy and kidney transplant
- Introduction—Immune check point inhibitors (ICI) use in solid organ transplant recipients
- ICI use in solid organ transplant recipients
- Mechanism of T-cell activation and regulation—Role in ICI therapy and solid organ transplantation
- Immune check point inhibitor use in solid organ transplants
- Current usage of ICI in cancers
- Previous experience
- Mechanism of SOT rejection after ICI
- Loss of T-cell regulation
- Histopathological studies
- Immune suppression role to prevent SOT rejection
- Effect of immunosuppression on tumor progression and survival
- Tumor response versus graft survival
- Belatacept
- Early markers of rejection
- Gene expression studies
- Conclusion
- Chapter 10. Immunotherapy and hematopoietic stem cell transplantation
- Background
- Historical background from the beginnings of hematopoietic stem cell transplantation
- Types of hematopoietic stem cell transplantation
- Autologous stem cell transplantation
- Allogeneic stem cell transplantation
- Patient and donor selection for transplant
- Patient and disease assessments
- Donor assessment
- Graft source and stem cell dose
- Donor HLA compatibility and donor choice
- Donor health assessment
- Conditioning regimen
- Myeloablative conditioning (MAC)
- TBI-based regimens
- High-dose chemotherapy-based regimens
- Non-myeloablative (NMA) and reduced-intensity conditioning (RIC)
- GVHD prophylaxis
- Matched sibling donor (MSD)
- Matched unrelated donor (MUD)
- Haploidentical donor
- Posttransplant complications
- Graft failure
- GVHD
- Infections
- VOD/SOS
- Late complications
- Conclusion
- Chapter 11. Immunotherapy in the era of transplant oncology: Risks and complications
- Introduction
- Current landscape of immunotherapy
- CTLA-4 inhibitors
- PD-L1 and PD-1 inhibitors
- LAG-3 inhibitors
- Use of immunotherapy in solid organ transplant recipients
- Molecular features of solid organ transplant rejection
- Safety of immunotherapy use in solid organ transplant recipients
- Tumor responses to immunotherapy in SOTRs
- Prevention and management of immunotherapy-induced solid organ transplant rejection
- Future directions
- Chapter 12. Immunotherapy and immunosuppressants: Considerations in the clinical practice
- Introduction: Epidemiology of cancers post-kidney transplant
- Immunosuppression management in patients with cancer
- Use of immune checkpoint blockade in kidney transplant
- Risk of rejection
- Management of immunosuppression for patients receiving ICI
- Shared decision making in use of ICI
- CAR-T therapies immunosuppression management and rejection risk
- Conclusion
- Section IV. Transplant oncology and precision medicine
- Chapter 13. Molecular profiling and next-generation sequencing applications in transplant oncology
- Introduction
- How to implement molecular profiling into liver transplant care
- Potential roles of molecular profiling by stage of liver transplant care
- At referral and evaluation for germline cancer predisposition
- At referral and evaluation for cancer screening and diagnosis
- At waitlist and liver transplant, for prognosis
- At waitlist and liver transplant, for predicting therapeutic responses
- Follow up, for minimal residual disease and cancer surveillance
- Implementation barriers
- Patient recruitment/compliance
- Specimen acquisition/transport
- Testing cost/scale/turnaround time
- Multidisciplinary molecular tumor board
- Actionability: Follow-up tests, targeted therapies, trial access
- Summary
- Chapter 14. Circulating tumor DNA (ctDNA) as a new and evolving tool in solid organ transplantation
- Liquid biopsy—An introduction
- ctDNA platforms
- Transplant oncology
- Screening or early detection
- Minimal residual disease (MRD) detection
- Genotyping for actionable markers
- The road ahead
- Chapter 15. Cell-free DNA (cfDNA) biomarkers for solid organ transplant rejection
- Introduction
- Characterization of cell-free DNA
- Concentration
- Epigenetic modifications
- Fragment size
- Clearance kinetics
- Assays
- Kinetics of donor-derived cell-free DNA (dd-cfDNA) levels in recipients with stable grafts
- Cell-free DNA and graft rejection in post transplantation
- Liver
- Kidney and kidney-pancreas allografts
- Lung and heart
- Implementation in clinical practice
- Chapter 16. Artificial intelligence in transplant oncology
- Introduction
- Conceptual overview of artificial intelligence
- Data preparation
- Algorithm selection
- Model performance
- Overview of AI applications in transplant oncology
- Hepatocellular carcinoma
- Early detection and diagnosis
- Prognosis and risk-stratification
- Waitlist prioritization
- Recurrence risk
- Markers of tumor aggressiveness
- Guidance of management strategy
- Downstaging tumors
- Postoperative management
- Cholangiocarcinoma
- Early detection and diagnosis
- Prognosis and risk-stratification
- Treatment selection
- Colorectal liver metastases
- Lesion detection and prediction
- Risk of metastases
- Diagnosis and classification
- Prognostication and treatment selection
- Limitations
- Conclusion
- Section V. Solid organ transplant and cancers considerations
- Chapter 17. De-novo malignancy post liver transplantation: Recent insights on epidemiology and surveillance strategies
- Introduction
- Epidemiology
- Risk factors for developing DNMS
- Hepatocellular carcinoma recurrence
- Pathophysiology
- Screening for DNMS
- Skin cancers
- PTLD
- Colorectal cancer
- Prevention of DNMS and future directions
- Conclusion
- Chapter 18. History of cancer and transplant clearance: Considerations prior to transplantation
- Introduction
- The American Association for the Study of Liver Disease (AASLD) guideline for liver transplantation with a previous history of cancer
- Preexisting cancer and orthotopic liver transplantation
- Preexisting breast cancer and liver transplantation
- Preexisting colorectal cancer and liver transplantation
- Preexisting non-small cell lung cancer and liver transplantation
- Preexisting gynecologic cancers and liver transplantation
- Emerging considerations for liver transplant with preexisting cancers
- Transplants from a deceased/living donor who had cancer
- The difference between the deceased donor and the living donor in liver transplantation
- Donors with preexisting melanoma
- Donors with preexisting choriocarcinoma
- Donors with preexisting CNS tumors
- Donors with preexisting breast cancer
- Donors with preexisting hematologic malignancies
- Donors with preexisting renal cell cancer
- Recurrence and survival after the liver transplantation
- Conclusion
- Section VI. Surgical aspects of transplant oncology
- Chapter 19. Robotic surgery for liver cancer and applications in liver transplantation
- Introduction
- Robotic surgery for liver cancer
- History of robotic surgery for HPB surgery and liver cancer
- Modern outcomes after robotic HPB surgery
- Oncologic outcomes after robotic surgery for liver cancer
- Robotic liver transplantation for liver cancer
- History of liver transplantation for primary and secondary liver cancers
- Minimally invasive surgery and liver transplantation
- Robotic living donor hepatectomy
- Robotic recipient liver transplantation
- Summary
- Abbreviations
- Chapter 20. Resection versus transplantation for intrahepatic and hilar cholangiocarcinoma
- Introduction
- Hilar cholangiocarcinoma
- Intrahepatic cholangiocarcinoma
- Conclusion
- Chapter 21. Liver transplantation for secondary liver cancers: Surgical considerations
- Introduction
- History of liver transplantation for secondary tumors
- Colorectal cancer liver metastases
- Colorectal cancer: Overview and incidence
- Colorectal cancer biology and pathology
- CRLM case selection
- Timing of liver transplantation
- Tumor staging
- Neoadjuvant treatment
- Biomarkers and CRLM patient selection
- Recipient medical contraindications
- Donor factors and selection for patients with CRLM
- Deceased donor liver transplantation
- Living donor liver transplantation
- Insurance considerations for patients with CRLM
- Surgical aspects of liver transplantation for CRLM
- Neuroendocrine tumor metastases
- Prevalence, incidence, and epidemiology
- Pathology
- Carcinoid syndrome and crisis
- Diagnosing neuroendocrine tumors
- Laboratory
- Radiological tests
- Treatment with somatostatin analogues, peptide receptor radionucleotide therapy
- Peptide receptor radionucleotide therapy (PRRT)
- Somatostatin analogues (SSAs)
- Hepatectomy for metastatic neuroendocrine tumors
- Liver transplantation for gastroenteropancreatic neuroendocrine tumors
- Living donor liver transplantation for metastatic NETs
- Surgical nuances of liver transplantation for NETs
- Management of immunosuppression
- Management of post-transplant recurrence
- Chapter 22. New strategies for two-stage hepatectomy
- Introduction
- The surgical procedure
- Step 1
- Step 2
- Challenges in the two-stage hepatectomy in liver transplantation
- The utilization of living donors
- Emerging horizons
- Conclusion
- Chapter 23. Living donor liver transplantation
- History
- Transplant oncology
- Living donors: Evaluation and considerations
- Ethical considerations
- Donor quality and medical considerations
- Donor operation
- Living donor hepatectomy
- Open versus minimally invasive donor hepatectomy
- Recipient evaluation
- Recipient operation
- Recipient transplant hepatectomy
- Living donor liver transplantation
- Minimally invasive recipient surgery
- Surgical considerations
- Outcomes of LDLT
- Transplant oncology and LDLT
- LDLT for hepatocellular carcinoma
- LDLT for hilar cholangiocarcinoma
- LDLT for intrahepatic cholangiocarcinoma
- LDLT for colorectal liver metastases
- Future directions
- Chapter 24. Patient characteristics and evaluations prior to liver transplantation
- Introduction
- Liver-related considerations
- Tumor stage
- Metastasis and microvascular invasion
- Non-invasive imaging
- To biopsy or not to biopsy
- Infection evaluation
- Prognostic immunohistochemistry staining
- Mutations
- Alpha-fetoprotein levels
- MELD score and liver transplant
- CtDNA levels
- Neoadjuvant
- Patient considerations
- Sex
- Obesity
- Psychiatric evaluation
- Tobacco consumption
- Conclusion
- Chapter 25. Challenges of liver transplantation for transplant oncology indications
- Outline/Introduction of the chapter
- Patient selection for liver transplantation in transplant oncology
- Organ availability: The donor organ shortage problem
- Peri-transplant management
- Locoregional therapy
- Systemic therapy
- Intraoperative challenges
- Cell salvage
- Effect of neoadjuvant therapy on the transplant procedure
- Transplantation techniques
- Posttransplant management
- Immunosuppression
- Risk of recurrence
- Management of recurrence
- Expanding indications and challenges in study design
- Chapter 26. Future of transplant oncology of the liver
- Introduction
- Normothermic machine perfusion (NMP) in liver transplantation: Advancing organ preservation
- Expanding the donor pool and minimizing ischemia
- Future directions and challenges
- Hypothermic Machine Perfusion (HMP) in liver transplantation
- Principles of Hypothermic Machine Perfusion
- Clinical outcomes and efficacy
- Mitigating ischemia-reperfusion injury
- Optimizing organ assessment and viability
- Future directions and challenges
- Future techniques
- Gene editing technologies in liver transplant oncology: The CRISPR-Cas9 revolution
- Personalized patient selection and outcomes prediction
- Biomarkers for early detection of liver transplant-related complications
- Navigating the precision frontier in liver transplant oncology
- Collaboration between oncologists and transplant specialists
- The impact of artificial intelligence on Multidisciplinary Tumor Boards in liver transplant oncology
- Personalized treatment planning
- Enhanced decision support in MTBs
- Challenges and considerations
- A paradigm shift in transplant oncology decision-making
- Paving the way for transformative transplant oncology
- Index
- Edition: 1
- Published: November 8, 2024
- No. of pages (Paperback): 360
- No. of pages (eBook): 245
- Imprint: Academic Press
- Language: English
- Paperback ISBN: 9780443219016
- eBook ISBN: 9780443219023
MA
Maen A. Abdelrahim
Dr. Abdelrahim is a gastrointestinal medical oncologist and transplant oncologist with unique experience in malignancies treated by liver transplantation. He is the section chief of GI medical oncology at Houston Methodist Neal Cancer Center.
He is heavily involved in the transplant oncology field and have been one of the pioneers in the field. He has published more than 230 original research articles, review articles, and book chapters in prestigious journals and publishing groups. He is a member of the American Society of Clinical Oncology, Society for Immunotherapy of Cancer, Cholangiocarcinoma Foundation, European Society for Medical Oncology, and International Liver Transplant Society
Affiliations and expertise
Houston Methodist, Section, Chief Gastrointestinal Medical Oncology, Medical Director Cockrell Center for Advanced Therapeutics (CCAT), Houston, TX, USARead Transplant Oncology on ScienceDirect