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PLASTIC RECONSTRUCTIVE AND REGENERATIVE SURGERY

Abstract

Alongside transplant oncology, transplant oncology nursing is emerging as a specialized branch of modern nursing dedicated to providing oncologic patients with innovative treatment options. Besides hematopoietic stem cell
transplantation (HSCT), limited information is available about the scope, responsibilities, and role of transplant nurse specialists in this developing field. This paper aims to outline, in a narrative style, the role of transplant oncology
nursing in helping achieve the discipline’s therapeutic goals and the challenges faced in its clinical implementation. Four clinical areas of nursing care are identified: patients with malignancies as an indication for transplantation; patients with pre-transplant malignancies; de novo cancer after transplantation; and donor-related cancer transmission. These areas cover the entire donation and transplantation process, from donor procurement to pre- and post-transplant care, involving nurses working in ICUs, ORs, transplant clinics, and procurement units at both local and national levels. Transplant nurses are encouraged to embrace this evolving field in transplantation by
establishing evidence-based practices, fostering interprofessional and interdisciplinary collaboration, and addressing the ethical dilemmas that arise from complex medical conditions. As this field is subject to rapid changes, ongoing review of nursing practices is necessary to optimize care based on the emerging clinical needs of transplant oncology patients.

Abbreviations

AZA: azathioprine

CNI: calcineurin inhibitor

CRC: colorectal cancer

CyA: cyclosporine

DCD: donor after cardiocirculatory death

ECD: extended criteria donors

HCC: hepatocellular carcinoma

EHE: hepatic hemangioendothelioma epithelioid

HCC: hepatocellular carcinoma

HSCT: hematopoietic stem cell transplant

HT: heart transplantation

ICU: intensive care unit

IPMN: intraductal papillary mucinous neoplasm

KT: kidney transplantation

LT: liver transplantation

MGUS: monoclonal gammopathy of undetermined significance

mTOR: mammalian target of rapamycin

mTORi: mammalian target of rapamycin inhibitors

OPTN: Organ procurement and transplantation network

OR: operating room

PTLD: post-transplant lymphoproliferative disease

RCC: renal cell cancer

SOT: solid organ transplantation

TCCN: transitional care nurse navigator

UNOS: United Network for Organ Sharing

INTRODUCTION

The growth of transplantation as a medical field has been accompanied by the development and progress of donation and transplant nursing 1. The increasing complexity of transplant medicine has led to the creation of nursing roles for procurement procedures, donor surgery, pre- and post-transplant recipient care, as well as the coordination of the complex processes involved in identifying, maintaining, and utilizing organ donors 2. Transplant nurses are involved throughout the entire donation and transplantation network, working in local transplant centers (as transplant coordinators), intensive care units (ICUs), operating rooms (ORs), in-hospital procurement coordination units (i.e., procurement coordinators), and regional, interregional, and national transplant service authorities 3. Although the normative frameworks and certification requirements vary, the scope, responsibilities, and mission of transplant nursing are somewhat consistent across different countries, and transplant nurses play a vital role in procurement and transplant care 1-3.

One key characteristic of transplant nurses is their ability to promote the development of medical and surgical practices in transplant medicine, from research to clinical implementation 4. All major advances in transplant care have contributed to increased expertise in procurement and transplant nursing, supporting the adoption of technological breakthroughs in clinical practice and improving patients’ access to care 5. One notable example is the ongoing expansion of donation after cardiocirculatory death (DCD), which has driven the introduction of new therapeutic strategies and procedures and raised ethical questions within the nursing community 5-7. Implementation of solid organ transplant (SOT) programs from DCDs, however, still requires appropriate educational initiatives for transplant nurses and paramedics to help align clinical practice with these technical advances 7.

Although individual nurse workload does not consist solely of direct patient care, it is currently estimated that nurses handle 80% of ward care 8. Over time, their skills have expanded significantly from task-focused roles to include indirect patient care, such as documenting patient information, communicating with other healthcare professionals, coordinating care, managing medications, advocating for patients, and providing education 8. Despite most physicians recognizing the vital role nurses play in enhancing patient care, their perceptions of this role can vary 9. The nurses’ role has often been embedded within medical-driven and physician-led clinical care structures, leading to strained interprofessional relationships and contributing to a nursing workforce shortage 10. Among various strategies to increase nurses’ involvement and responsibilities (i.e., teamwork), interprofessional educational initiatives that focus on healthcare professionals’ roles, attitudes, perceptions, and expectations are essential for expanding patient care, improving outcomes, and facilitating the integration of scientific advancements into clinical practice 11.

The recent growth of transplant oncology has mainly involved physicians, while the role of nurses has been only partially addressed in relation to hematopoietic stem cell transplantation (HSCT) 12. This paper aims to narratively analyze how transplant oncology impacts nursing across the entire continuum of care, from ICUs and transplant clinics to procurement units and organizations, to support greater integration of nurses into this evolving field.

TRANSPLANT ONCOLOGY NURSING

Oncology nurses must have specific training and skills to recognize and manage symptoms, support patients with self-care, provide health promotion advice, coordinate care, and refer patients to appropriate services 13. In the oncology field, several nursing organizational models have been described, such as the Transitional Care Nurse Navigator (TCNN) 14 and the Nurse Chronic Care Coordinators 15. The choice of model to implement must consider factors related to the patient, the healthcare system, and policy 13, and it must be based on patient-centered care and patient empowerment 16.

Along with the recently introduced term “transplant oncology,” which has gained prominence in the transplantation field, “transplant oncology nursing” should be adopted to describe specific clinical nursing scenarios: 1) nursing care for patients with malignancies as an indication for SOT (e.g., patients with hepatocellular carcinoma (HCC) undergoing liver transplantation (LT)); 2) nursing care for patients on the waitlist for SOT with pre-transplant malignancies; 3) nursing care for patients with new-onset malignancies after transplantation; and 4) nursing care for patients at risk of donor-transmitted malignancies (Fig. 1).

Notably, transplant oncology nursing involves more than just merging responsibilities and functions from oncology and transplant care. Transplant oncology patients are unique among SOT candidates and recipients because they encounter specific challenges related to their disease, medical and surgical histories, neo-adjuvant and adjuvant treatments, and anticipated outcomes. Additionally, these patients’ psychological experiences – burdened by concerns about not receiving a transplant in time or failing to be transplanted due to disease progression – necessitate awareness, knowledge, and expertise from nurses and healthcare personnel, along with effective coping strategies 17.

TRANSPLANT NURSING FOR PATIENTS WITH MALIGNANCIES AS AN INDICATION

LT is the area that has seen the most extensive use of transplant oncology so far, with transplantation for HCC being widely performed 18. Recently, colorectal cancer (CRC) liver metastases, neuroendocrine tumors, and cholangiocarcinoma are being increasingly considered 19,20. Additionally, incidental or intentional transplantation of patients with rare malignancies has also been reported 21. In pediatric and young adult populations, hepatoblastoma – the most common primary liver cancer in children – and vascular tumors (i.e., hepatic hemangioendothelioma and epithelioid hemangioendothelioma, EHE) have specific indications for LT when surgery is deemed unsuitable 22,23. Contrary to what is usually believed, malignancies can seldom be an indication for kidney transplantation (KT) 24,25, lung transplantation 26, and, although controversial, even for heart transplantation 27. Finally, uterus transplantation can be a treatment option to restore fertility in female patients with a history of uterine or ovarian cancer 28.

Successfully managing these patients requires a structured approach that emphasizes the integration of interprofessional and multidisciplinary care 29. Nurse-focused initiative strategies to facilitate the implementation of transplant oncology in the clinic should concentrate on 1) implementing evidence-based nursing practices, 2) fostering interdisciplinary and interprofessional collaboration, and 3) helping nurses address ethical dilemmas (Tab. I).

Implementing evidence-based nursing practices involves systematically combining the best available research evidence with clinical expertise and patient values to guide healthcare decisions and improve patient outcomes 30. It requires a comprehensive approach that includes identifying clinical questions, finding relevant research, critically evaluating the evidence, applying the findings, and assessing the results 30. A supportive environment, proper education, and ongoing assessment are crucial for successful EBP implementation 30. In SOT oncology, however, most available evidence has been derived from case reports and single-center cohorts, with few randomized studies. As a result, transplant oncology nursing still lacks clinical guidelines 19,20,31.

Promoting interdisciplinary and interprofessional collaboration is crucial in transplant nursing; however, there remains a lack of clarity regarding roles and responsibilities in transplant oncology nursing. This is especially important because of the complexity of clinical pathways for oncology patients referred for transplantation and the need for organized, well-timed procedures 32. Quite often, referrals are unstructured, left to the patient’s discretion, and hampered by clinical pathways that are fragmented across multiple professionals and institutions 33. This could lead to delays, inappropriate referrals, and missed opportunities for patients who might benefit from transplantation. Standardizing the referral process through technology, such as web-based portals and electronic referral systems, provides consistent information to reduce patients’ hesitancy and confusion, and eliminates interprofessional barriers related to cognitive, cultural, and technical differences. These initiatives aim to expand access to transplant oncology and facilitate early referral.

Transplant nursing presents ethical dilemmas that arise from balancing patient care, personal values, and the limited resources available 34. Transplant oncology can intensify these dilemmas due to the complex medical histories of oncology patients and their increased psychological vulnerability. Unlike oncology treatments, transplantation depends on scarce resources like donor grafts, whose limited availability can threaten the chances of a cure for waitlisted patients. Nurses often face the challenge of ensuring that patients and their families fully understand the implications of organ donation and transplantation, especially when working with vulnerable individuals or patients with reduced cognitive capacities 34. The dynamics of transplant candidacy and waitlist priorities can be difficult to communicate to oncology patients, who may prioritize their medical urgency over the needs of the waitlisted population. Additionally, patients must be informed that neoadjuvant therapies may be necessary while waiting for an organ (e.g., immunotherapy or radiology-assisted tumor downstaging before LT), and that adjuvant treatments might be required after transplantation (e.g., chemotherapy for CRC after LT) 20. Nurses often experience moral distress when faced with situations that conflict with their personal values or professional ethics. This can be especially acute in transplantation oncology due to the high stakes and emotional intensity of the process 35.

NURSING CARE FOR PATIENTS WITH PRE-TRANSPLANT MALIGNANCIES AND DE NOVO TUMORS AFTER TRANSPLANTATION

Except when malignancies justify SOT, active tumors are generally a contraindication. However, this view has been challenged by discussions about the urgency of transplantation for patients with no other options (i.e., the so-called transplant benefit). Additionally, patients with precancerous lesions, low-grade tumors, or neoplasms that can be treated during the eligibility or waitlist period without reducing their chances of receiving a transplant can be listed with favorable outcomes 36. As advances in cancer therapies lead to better prognosis and survival, more individuals with a history of cancer are likely to require SOT. The use of SOT in patients with pre-transplant malignancies has increased significantly in recent decades (< 1% in 1994 to 8.3% in 2016 for kidney transplant recipients) 37. The risk of cancer recurrence and the potential for worse outcomes following SOT must be balanced against the benefits of the transplant (lifesaving vs. life-prolonging), while also considering alternative options (e.g., dialysis and ventricular assist devices) 37.

The main concern when evaluating patients with pre-transplant malignancy is that immunosuppression (IS) could raise the risk of cancer recurrence, potentially affecting post-transplant survival 38. The most common guidelines for selecting patients were adapted from recommendations made for KT recipients 39. In most cases, at least two years is advised between cancer treatment and SOT 37,39. Two-year waiting periods are recommended even for cancers with very low or no risk of recurrence, such as ductal carcinoma in situ of the breast 37. For cancers with a higher risk of recurrence, longer wait times – ranging from two to five years or more – are suggested, though supported by limited data 37. Data from the Israel Penn International Transplant Tumor Registry, which includes transplant recipients with pre-transplant malignancies, reported a 21% overall risk of cancer recurrence after SOT, with higher rates observed in certain high-risk cancers 40.

However, more recent population-based studies have reported lower cancer recurrence rates than the original registry data, although poorer outcomes still occur in those with PTM 37,41. Recent studies also show a higher incidence of all-cause mortality in SOT recipients with pre-transplant malignancies compared to those without. Yet, the cause of death is not solely linked to cancer recurrence and can be explained by the complex medical and surgical history of these patients 42. Despite these increased risks, overall patient survival may still be better than expected without transplantation (i.e., net survival benefit gain). It could be considered acceptable for transplant-specific outcomes (i.e., transplant benefit).

Alongside pre-transplant malignancies, a crucial area in transplant oncology is caring for recipients with de novo tumors 43. Recent meta-analyses have highlighted a 20-fold increased risk in transplant recipients compared to age- and sex-matched populations, especially for those who received treatment based on cyclosporine (CyA) or azathioprine (AZA) 43. Transplant nurses play a crucial role in this field by collaborating with healthcare professionals and facilitating effective communication with patients during both the pre- and post-transplant phases. The risk of recurrence or de novo occurrence can vary depending on the transplanted organ and the immunosuppression regimen used 37. Lung recipients face the highest risk, as they often undergo the most intensive immunosuppression 37. Nurses can help implement pre- and post-transplant lifestyle habits to reduce this risk by establishing smoking cessation programs and supporting recipients in weight management, alcohol abstinence, and nutritional guidance 44. They can also monitor patients’ adherence to follow-up visits and surveillance protocols, thereby helping optimize outcomes for recipients at higher risk of post-transplant tumor recurrence 44,45 (Tab. II).

DONOR-RELATED CANCER TRANSMISSION

Despite efforts to ensure organ transplant safety, donor malignancy transmission can still occur, as documented in the literature 46. A recent Danish study using a population-based cancer registry found an 8 in 626 (1.3%) chance of a donor having an undetected malignancy and a 1 in 626 (0.2%) chance of transmitting cancer 46. The Organ Procurement and Transplantation Network (OPTN) registry review, involving 34,933 deceased donors and 108,062 recipients, reported 21 donor-related malignancies from 14 deceased and three living donors 47. Fifteen tumors were donor-transmitted (malignancies present in the donor at the time of transplantation), and six were donor-derived (de novo tumors that developed in transplanted donor hematogenous or lymphoid cells after transplantation) 47. Therefore, the cadaveric donor-related tumor rate was 0.04% (14 of 34,993), and the donor-related tumor rate among transplanted cadaveric organs was 0.017% (18 of 108,062) 47. Among patients with donor-related malignancies, the overall mortality rate was 38%, with transmitted tumors at 46% and derived tumors at 33% 47. The overall deceased donor-related tumor mortality rate was 0.007% (8 of 108,062) 47. Compared to the benefits of organ transplantation, these risks are minimal; however, reducing the risk of transmitting malignancies or other diseases from deceased and living donors remains crucial in the current era of extended criteria donors (ECD) and an aging donor and recipient population. Age is the most significant risk factor for cancer overall and for many specific cancer types 48. The incidence rates for cancer increase steadily with age- from fewer than 26 cases per 100,000 people in age groups under 20, to about 350 per 100,000 among those aged 45–49, and over 1,000 per 100,000 in age groups 60 years and older 48. The increasing age of deceased donors and transplant candidates, combined with the effects of post-transplant immunosuppression, is likely to lead to a rise in post-transplant malignancies in the coming years 49.

Transplant nurses can help reduce this risk by improving the efficiency and effectiveness of evaluation algorithms for both donors and recipients. Their approaches include cognitive, cultural, and behavioral methods, and involve donors, recipients, their families, and caregivers, depending on the type of donor (deceased versus living), transplant type, and the level of individual autonomy. Table III lists some of these initiatives.

CONCLUSIONS

Alongside transplant oncology, transplant oncology nursing is emerging as a vital subspecialty in the clinical field. Improving nursing care in this specialized area requires educational initiatives to keep nurses updated on technological and clinical advances; promoting evidence-based practices through critical review of current nursing protocols and their adaptation to this new patient population; and engaging all healthcare professionals, caregivers, and stakeholders involved in the donation and transplant process. As this field is subject to rapid changes, ongoing review of nursing practices is necessary to optimize care based on the emerging clinical needs of transplant oncology patients.

Conflict of interest statement

The authors declare no conflict of interest.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author contributions

DL, AS, JD: conceptualization, methodology; DL, CF, MM, CB, MRS, SC, SR: investigation; DL: writing – original draft, project administration; DL; AS, JD: writing – review and editing, supervision.

All authors have read and approved the final version of the manuscript.

Ethical consideration

Not applicable.

History

Received: June 24, 2025

Accepted: July 29, 2025

Figures and tables

Figure 1. The figure illustrates the different scenario of transplant oncology nursing in clinical practice.

Area Open issues
Implementing evidence-based nursing practices Except for HSCT, transplant oncology nursing has been limitedly explored in the scientific literature
In SOT, most studies are case reports, consecutive series, and single-center cohorts
SOT oncology nursing still lacks clinical guidelines
Fostering interdisciplinary and interprofessional collaboration Although transplant nursing is inherently interdisciplinary and interprofessional, a clear definition of roles and responsibilities in transplant oncology nursing is still lacking
This is even more necessary due to the high number of specialties and healthcare professionals involved
Patient referral still limited
Removing cognitive, cultural, and technical barriers among professionals is necessary
Helping nurses cope with ethical dilemmas Transplant oncology may heighten the ethical dilemmas that nurses experience due to the increased vulnerability of oncologic patients and their expectations about the success of the treatment process
Oncologic patients may have trouble in understanding the dynamics of transplant candidacy and waitlisting
Information on the need for pre- and post-transplant treatments (i.e., neoadjuvant, adjuvant) is often difficult to communicate
HSCT: hematopoietic stem cell transplantation; SOT: solid organ transplantation.
Table I. Initiatives in view of optimizing nursing care for patients with malignancies as an indication.
Area Open issues
Integration of evidence in the clinic Newer oncological therapies are improving survival of patients with cancer
There is a constant increase in the number of patients with pre-transplant malignancies being referred for SOT
Recent evidence suggests that recipients with pre-transplant malignancies have a higher risk of cancer recurrence due to post-transplant immunosuppression and all-cause mortality
However, these risks are improving due to the availability of newer immunosuppressants (mTORi), better use of immunosuppression and availability of tumor treatment strategies even in the post-transplant settings
The expected survival rates of patients with pre-transplant malignancies can meet acceptable efficacy thresholds despite a higher risk of relapse
Helping pre- and post-transplant patients coping with prescriptions and lifestyle indications aiming at reducing the cancer recurrence risk Getting exhaustive information on pre-transplant malignancies clinical history and care needs (i.e., nutritional counseling) may be burdensome
Implement proactive participation of potential transplant candidates and recipients to: alcohol abstinence smoking cessation weight control glucose metabolism control exercise programs adherence to follow-up visits adherence to pre- and post-transplant treatments skin care and protection
mTORi: mammalian target of rapamycin inhibitors; SOT: solid organ transplantation.
Table II. Initiatives in view of optimizing nursing care for patients with pre-transplant malignancies and de novo tumors after transplantation.
Area Strategies
Increase the efficiency and effectiveness of deceased and living donors’ evaluation algorithms Interact with healthcare personnel, GPs, specialty physicians, nurses, consultants, and caregivers to gather information about donors’ medical history
Explore risky behaviors and lifestyle habits that could increase the risk of hidden malignancies
Obtain comprehensive medication information using all available resources (e.g., healthcare professionals, electronic systems, family members)
Consider previous use of anti-cancer medications that donors and their families may have overlooked by asking explicit questions
Do not exclude donors’ eligibility based solely on the assumption that a prior malignancy automatically contraindicates organ transplantation
Do not exclude donors’ eligibility based solely on the presence of an active malignancy
Facilitate accurate cancer staging by implementing appropriate diagnostic protocols
If a cancer diagnosis occurs before procurement, refer to society guidelines and procurement agencies
Convey the results of the pre-procurement cancer workup honestly and directly to (living) donors and their families
Develop coping strategies for living donors and their families if they are deemed unsuitable for donation
Facilitate intraoperative and postoperative diagnosis of hidden or known malignancies by coordinating collaboration among professionals such as radiologists, pathologists, oncologists, and surgeons
Increase the efficiency and effectiveness of recipients’ surveillance algorithms Promote adherence to cancer surveillance protocols among transplant professionals, recipients, and their families.
Facilitate access to surveillance programs for individuals experiencing physical, cognitive, or social vulnerability
Avoid stigmatizing risky lifestyles linked to higher rates of cancer, such as promiscuous sexual behavior, alcohol abuse, smoking, and illicit drug use
Tailor cancer surveillance programs for at-risk patients, such as those requiring increased immunosuppression, patients with a pre-transplant history of malignancies, and those who are rarely adherent and miss follow-up appointments
Table III. The role of nursing in reducing the risk of donor-related cancer transmission.

References

  1. Longo D, Ramacciati N, Giusti G. Nurse specialist in the organ and tissue donation process with coordination role: a scoping review. Nurs Rep. 2025;15. doi:https://doi.org/10.3390/nursrep15020039
  2. Tocher J, Neades B, Smith G. The role of specialist nurses for organ donation: a solution for maximising organ donation rates?. J Clin Nurs. 2019;28:2020-2027. doi:https://doi.org/10.1111/jocn.14741
  3. Manyalich M. Evolución del procuramiento de órganos en el mundo. Rev. Médica Clínica Condes. 2010;21:145-151. doi:https://doi.org/10.1016/S0716-8640(10)70518-6
  4. Cerulus M, Duerinckx N, Dobbels F. The Organisation and implementation of nurse-led clinics: lessons learned from the experiences in five countries. J Adv Nurs. Published online 2025. doi:https://doi.org/10.1111/jan.17012
  5. Kondori J, Ghafouri R, Zamanzadeh V. Emergency medical staffs’ knowledge and attitude about organ donation after circulatory determined death (DCD) and its related factors. BMC Emerg Med. 2021;21. doi:https://doi.org/10.1186/s12873-021-00485-5
  6. Lee Y, Ranse K, Silvester W. Attitudes and self-reported end-of-life care of Australian and New Zealand intensive care doctors in the context of organ donation after circulatory death. Anaesth Intensive Care. 2018;46:488-497. doi:https://doi.org/10.1177/0310057X1804600510
  7. Pabisiak K, Krejczy A, Bohatyrewicz R. Underestimated role in the organ donation pathway-paramedics’ attitudes and knowledge about donation after circulatory death. Transplant Proc. 2018;50:1953-1956. doi:https://doi.org/10.1016/j.transproceed.2018.02.111
  8. Yen P, Kellye M, Lopetegui M. Nurses’ time allocation and multitasking of nursing activities: a time motion study. AMIA Annu Symp Proc. 2018;2018:1137-1146.
  9. Arends S, Thodé M, Pasman H. How physicians see nurses’ role in decision-making about life-prolonging treatments in patients with a short life expectancy: an interview study. Patient Educ Couns. 2023;114. doi:https://doi.org/10.1016/j.pec.2023.107863
  10. Steinbrook R. Nursing in the crossfire. N Engl J Med. 2002;346:1757-1766. doi:https://doi.org/10.1056/NEJM200205303462225
  11. Krecko L, Stalter L, Pavuluri Q. Discussion-based interprofessional education: a positive step toward promoting shared understanding between surgical residents and nurses. J Interprof Care. 2023;37:974-989. doi:https://doi.org/10.1080/13561820.2023.2206434
  12. Fauer A, Choi S, Friese C. The roles of nurses in hematopoietic cell transplantation for the treatment of leukemia in older adults. Semin Oncol Nurs. 2019;35. doi:https://doi.org/10.1016/j.soncn.2019.150960
  13. Jefford M, Howell D, Li Q. Improved models of care for cancer survivors. The Lancet. 2022;399:1551-1560. doi:https://doi.org/10.1016/S0140-6736(22)00306-3
  14. Rodriguez A, Cappelletti L, Kurian S. Transitional Care Navigation. Semin Oncol Nurs. 2024;40. doi:https://doi.org/10.1016/j.soncn.2024.151580
  15. Flieger S, Thomas C, Prottas J. Improving interorganizational coordination between primary care and oncology: adapting a chronic care management model for patients with cancer. Med Care Res Rev. 2021;78:229-239. doi:https://doi.org/10.1177/1077558719870699
  16. Pituskin E. Cancer as a new chronic disease: Oncology nursing in the 21st Century. Can Oncol Nurs J. 2022;32:87-92.
  17. Wong G, Lim W. Prior cancer history and suitability for kidney transplantation. Clin Kidney J. 2023;16:1908-1916. doi:https://doi.org/10.1093/ckj/sfad141
  18. Horwitz J, Agopian V. Indication of liver transplant for hcc: current status and future directions. Curr Hepatology Rep. 2024;2:185-192. doi:https://doi.org/10.1007/s11901-024-00641-y
  19. Abdelrahim M, Esmail A, Abudayyeh A. Transplant oncology: an evolving field in cancer care. Cancers (Basel). 2021;13. doi:https://doi.org/10.3390/cancers13194911
  20. Fukumitsu K, Ito T, Kageyama S. Liver transplantation as a new treatment option for perihilar cholangiocarcinoma and colorectal liver metastases: a review. Int J Clin Oncol. Published online 2025. doi:https://doi.org/10.1007/s10147-025-02820-3
  21. Houben P, Schimmack S, Unterrainer C. Rare malignant indications for liver transplantation: a collaborative transplant study report. Front Surg. 2021;8. doi:https://doi.org/10.3389/fsurg.2021.678392
  22. Meyers R, Tiao G, Dunn S. Liver transplantation in the management of unresectable hepatoblastoma in children. Front Biosci (Elite Ed). 2012;4:1293-1302. doi:https://doi.org/10.2741/e460
  23. Lai Q, Feys E, Karam V. Hepatic epithelioid hemangioendothelioma and adult liver transplantation: proposal for a prognostic score based on the analysis of the ELTR-ELITA registry. Transplantation. 2017;101:555-564. doi:https://doi.org/10.1097/TP.0000000000001603
  24. Frascà G, Brigante F, Volpe A. Kidney transplantation in patients with previous renal cancer: a critical appraisal of current evidence and guidelines. J Nephrol. 2019;32:57-64. doi:https://doi.org/10.1007/s40620-018-0542-y
  25. Dahle D, Skauby M, Langberg C. Renal cell carcinoma and kidney transplantation: a narrative review. Transplantation. 2022;106:E52-E63. doi:https://doi.org/10.1097/TP.0000000000003762
  26. Lee J, Schellenberg S, Chung L. Current and future role of double-lung transplantation for bilateral lung cancer. Transplant Rev (Orlando). 2023;37. doi:https://doi.org/10.1016/j.trre.2023.100772
  27. Wingo M, de Biasi A, Shudo Y. Cardiac transplantation for cancer involving the heart. J Heart Lung Transplant. 2020;39:974-977. doi:https://doi.org/10.1016/j.healun.2020.05.010
  28. Dahm-Kähler P, Kvarnström N. Uterus transplantation for fertility preservation in patients with gynecologic cancer. Int J Gynecol Cancer. 2021;31:371-378. doi:https://doi.org/10.1136/ijgc-2020-001804
  29. Krendl F, Bellotti R, Sapisochin G. Transplant oncology – Current indications and strategies to advance the field. JHEP Rep. 2023;6. doi:https://doi.org/10.1016/j.jhepr.2023.100965
  30. Munten G, Van Den Bogaard J, Cox K. Implementation of evidence-based practice in nursing using action research: a review. Worldviews on Evidence-Based Nursing. 2010;7:135-157. doi:https://doi.org/10.1111/j.1741-6787.2009.00168.x
  31. Adam R, Piedvache C, Chiche L. Liver transplantation plus chemotherapy versus chemotherapy alone in patients with permanently unresectable colorectal liver metastases (TransMet): results from a multicentre, open-label, prospective, randomised controlled trial. Lancet. 2024;404:1107-1118. doi:https://doi.org/10.1016/S0140-6736(24)01595-2
  32. Natarajan B, Tabrizian P, Hoteit M. Downstaging hepatocellular carcinoma before liver transplantation: A multicenter analysis of the “all-comers” protocol in the Multicenter Evaluation of Reduction in Tumor Size before Liver Transplantation (MERITS-LT) consortium. Am J Transplant. 2023;23:1771-1780. doi:https://doi.org/10.1016/j.ajt.2023.07.021
  33. Sehgal A. Should transplant referral be a clinical performance measure?. J Am Soc Nephrol. 2017;28:721-723. doi:https://doi.org/10.1681/ASN.2016111169
  34. Omery A, Caswell D. A nursing perspective of the ethical issues surrounding liver transplantation. Heart Lung. 1988;17(6 Pt 1):626-631.
  35. Victorino J, de Brito E, Westin U. Health advocacy and moral distress among nurses in organ transplant units. Nurs Ethics. 2025;32:994-1003. doi:https://doi.org/10.1177/09697330241295368
  36. Al-Adra D, Hammel L, Roberts J. Pretransplant solid organ malignancy and organ transplant candidacy: a consensus expert opinion statement. Am J Transplant. 2021;21:460-474. doi:https://doi.org/10.1111/ajt.16318
  37. Mandlik D, Mandlik S, Choudhary H. Immunotherapy for hepatocellular carcinoma: current status and future perspectives. World J Gastroenterol. 2023;29:1054-1075. doi:https://doi.org/10.3748/wjg.v29.i6.1054
  38. Noone A, Pfeiffer R, Dorgan J. Cancer-attributable mortality among solid organ transplant recipients in the United States: 1987 through 2014. Cancer. 2019;125:2647-2655. doi:https://doi.org/10.1002/cncr.32136
  39. Kasiske B, Cangro C, Hariharan S. The evaluation of renal transplantation candidates: clinical practice guidelines. Am J Transplant. 2001;1:3-95.
  40. Penn I. Evaluation of the candidate with a previous malignancy. Liver Transpl Surg. 1996;2(5):109-113.
  41. Acuna S, Huang J, Dossa F. Cancer recurrence after solid organ transplantation: a systematic review and meta-analysis. Transplant Rev (Orlando). 2017;31:240-248. doi:https://doi.org/10.1016/j.trre.2017.08.003
  42. Livingston-Rosanoff D, Foley D, Leverson G. Impact of pre-transplant malignancy on outcomes after kidney transplantation: united network for organ sharing database analysis. J Am Coll Surg. 2019;229:568-579. doi:https://doi.org/10.1016/j.jamcollsurg.2019.06.001
  43. Zwart E, Yüksel E, Pannekoek A. De novo carcinoma after solid organ transplantation to give insight into carcinogenesis in general − A systematic review and meta-analysis. Cancers. 2021;13. doi:https://doi.org/10.3390/cancers13051122
  44. Gibson C, Gupta A, Naik A. Developing a Healthy lifestyle program for recent kidney transplant recipients. Progress in Transplantation. 2023;33:193-200. doi:https://doi.org/10.1177/15269248231189878
  45. Neuberger J. Follow-up of liver transplant recipients. Best Pract Res Clin Gastroenterol. 2020;46. doi:https://doi.org/10.1016/j.bpg.2020.101682
  46. Birkeland S, Storm H. Risk for tumor and other disease transmission by transplantation: a population-based study of unrecognized malignancies and other diseases in organ donors. Transplantation. 2002;74:1409-1413. doi:https://doi.org/10.1097/00007890-200211270-00012
  47. Kauffman H, McBride M, Cherikh W. Transplant tumor registry: donor related malignancies. Transplantation. 2002;74:358-362. doi:https://doi.org/10.1097/00007890-200208150-00011
  48. Rozhok A, DeGregori J. The evolution of lifespan and age-dependent cancer risk. Trends Canc. 2016;2:552-560. doi:https://doi.org/10.1016/j.trecan.2016.09.004
  49. Abecassis M, Bridges N, Clancy C. Solid-organ transplantation in older adults: current status and future research. Am J Transplant. 2012;12:2608-2622. doi:https://doi.org/10.1111/j.1600-6143.2012.04245.x

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Authors

Donato Longo - Department of Anesthesia and Intensive Care, “Vito Fazzi” Hospital, Lecce, Italy. Corresponding author - donato.longo@asl.lecce.it https://orcid.org/0000-0002-7716-0665

Chiara Favini - Hospital Coordination for organ and tissue donation, University Hospital of Sassari, Sassari, Italy https://orcid.org/0009-0009-7025-3891

Martina Managlia - Department of Anesthesia and Intensive Care, Hospital of Reggio Emilia, Italy https://orcid.org/0009-0007-4562-0763

Ciro Bellotta - Department of Anesthesia and Intensive Care, “Antonio Cardarelli” National Referral Hospital, Naples, Italy

Maria Rina Starace - Clinical Coordination of Liver Transplant, San Camillo Forlanini Hospital, Rome, Italy https://orcid.org/0009-0008-4004-5541

Simona Casaioli - Organ and tissue procurement unit, “Santa Maria della Misericordia” Hospital, Perugia, Italy https://orcid.org/0009-0001-0447-7266

Stefania Roncarati - Surgery Department, University Hospital of Ferrara, Ferrara, Italy https://orcid.org/0009-0001-2062-8845

Annarosa Saviozzi - Organ and tissue procurement unit, University of Pisa Medical School Hospital, Pisa, Italy

Juri Ducci - University of Pisa Medical School Hospital, Pisa, Italy

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Copyright (c) 2025 European Journal of Transplantation

How to Cite
[1]
Longo, D., Favini, C., Managlia, M., Bellotta, C., Starace, M.R., Casaioli, S., Roncarati, S., Saviozzi, A. and Ducci, J. 2025. Transplant oncology for donation and transplant nurses: a call to action. European Journal of Transplantation. 1, 3 (Sep. 2025), 54–62. DOI:https://doi.org/10.57603/EJT-1560.
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