Radiation Exposure and Attribute Cancer Risk after Lung Transplantation

• Published in: The Journal of heart and lung transplantation Vol. 32; no. 4; p. S267
• Main Authors: Rosengarten, D, Raviv, Y, Rosanov, V, More-Rahav, O, Fruchter, O, Allen, A.M, Kramer, M.R
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.04.2013
• Subjects: Surgery
• ISSN: 1053-2498; 1557-3117
• DOI: 10.1016/j.healun.2013.01.698

Purpose Survival of lung transplant recipients is improving constantly. During surveillance, patients are exposed to ionizing radiation from various imaging procedures, however, the cumulative radiation exposure and subsequent cancer risk after lung transplantation is not known. The purpose of this study was to estimate cumulative radiation exposure during follow-up after lung transplantation and its likely effect on the lifetime risk of cancer. Methods and Materials We included all patients who underwent lung transplantation at our center and survive at least 4 years since January 2000. Follow-up continued until March 21, 2012 or until death. We identified all procedures with radiation exposure and malignancies developed during study period. Estimation of the effective dose exposure and subsequent cancer risk were derived from previous reports. Results The study included 107 patients. Mean follow-up was 6.49±1.74 years for each patient (range 4-11). Radiation exposure during mean follow-up was 137.8 mSv. This represents an additional cancer risk of 0.55%. Chest X-ray was the most frequent procedure performed, nevertheless, CT scan contributed the largest radiation dose. A group of 24 cases of cancer in 21 patients (19.6%) were identified. Types of cancer are as follows: skin cancer-8 cases, lung cancer-6 cases, Transitional cell carcinoma-4 cases, post transplantation lymphoproliferative disease-2 cases, Kaposi sarcoma, Cholagiocarcinoma, Stomach carcinoma and Breast carcinoma-1 case each. The average radiation exposure in the group who developed cancer was 141.68±23 mSv and the average radiation exposure in the non-cancer group was 135.72±27 mSv. The difference between the two groups was not statistically significant (p=0.22). Conclusions Lung transplant recipients are exposed to 7.77 times greater radiation dose compared to radiation dose from medical imaging in the general population. Nevertheless, the lifetime increase in cancer risk due to radiation is small. Radiation exposure is not a major factor causing the increase in cancer incidence in lung transplant recipients.