Donor/recipient origin of lung cancer after lung transplantation by DNA short tandem repeat analysis

Julien De Wolf; Edouard Robin; Alexandre Vallee; Justine Cohen; Abdul Hamid; Antoine Roux; Morgan Leguen; Romane Beaurepere; Ivan Bieche; Julien Masliah-Planchon; Matthieu Glorion; Yves Allory; Edouard Sage; Foch lung transplant group

doi:10.3389/fonc.2023.1225538

Donor/recipient origin of lung cancer after lung transplantation by DNA short tandem repeat analysis

Front Oncol. 2023 Sep 28:13:1225538. doi: 10.3389/fonc.2023.1225538. eCollection 2023.

Authors

Julien De Wolf¹, Edouard Robin¹, Alexandre Vallee², Justine Cohen³, Abdul Hamid⁴, Antoine Roux⁴, Morgan Leguen^{5

6}, Romane Beaurepere⁷, Ivan Bieche⁷, Julien Masliah-Planchon⁷, Matthieu Glorion¹, Yves Allory^{3

8}, Edouard Sage^{1

6}; Foch lung transplant group

Affiliations

¹ Department of Thoracic Surgery and Lung Transplantation, Foch Hospital, Suresnes, France.
² Department of Clinical Research and Innovation Foch Hospital, Suresnes, France.
³ Department of Anatomopathology, Foch Hospital, Suresnes, France.
⁴ Department of Pneumology, Foch Hospital, Suresnes, France.
⁵ Department of Anesthesiology, Foch Hospital, Suresnes, France.
⁶ Université Paris-Saclay, INRAE, UVSQ, VIM, Jouy-en-Josas, France.
⁷ Genetics Department, Curie Institut, Paris, France.
⁸ Department of Anatomopathology, Curie Institut, Paris, France.

Abstract

Background: Lung cancer is more common in posttransplant recipients than in the general population. The objective of this study was to examine the chimerism donor/recipient cell origin of graft cancer in recipients of lung transplant.

Methods: A retrospective chart review was conducted at Foch Hospital for all lung transplantations from 1989 to 2020. Short tandem repeat PCR (STR-PCR) analysis, the gold standard technique for chimerism quantification, was used to determine the donor/recipient cell origin of lung cancers in transplant patients.

Results: Fourteen (1.4%) of the 1,026 patients were found to have graft lung cancer after lung transplantation, and one developed two different lung tumors in the same lobe. Among the 15 lung tumors, 10 (67%) presented with adenocarcinoma, four (27%) with squamous cell carcinoma and one with small cell lung cancer. STR analysis showed that the origin of the cancer was the donor in 10 patients (71%), the recipient in three patients (21%), and was undetermined in one patient. Median time to diagnosis was 62 months.

Conclusion: The prevalence of lung cancer in lung transplant recipients is very low. However, the results of our study showed heterogeneity of genetic alterations, with 21% being of recipient origin. Our results highlight the importance of donor selection and medical supervision after lung transplantation.

Keywords: STR; chimerism; desoxyribonucleic acid (DNA); donor; lung cancer; lung transplantation (LT); polymorphism chain reaction (PCR) transplantation; short tandem repeat (STR).