December 2025

UROLOGY

LUNG TRANSPLANTATION MAY TAKE PRIORITY IN MEN WITH HIGH-RISK PROSTATE CANCER

A Northwestern Medicine case report published in Clinical Transplantation explores lung transplantation in men with newly diagnosed high-risk prostate cancer. Traditionally, active malignancy is a contraindication for solid organ transplant due to concerns about cancer progression under immunosuppression. However, prostate cancer’s non-immunogenic nature and responsiveness to androgen deprivation therapy (ADT) offer flexibility to these guidelines.

The single-center review from 2018 to 2023 examined two patients with end-stage lung disease and WHO group III pulmonary hypertension who underwent lung transplantation before definitive cancer treatment. One received ADT pre-transplant and radiotherapy post-transplant; the other remains on active surveillance. Both are alive at 24- and 10-months post-transplant.

In select cases, prioritizing lifesaving lung transplantation over immediate cancer treatment is feasible. Expanding eligibility for patients with localized high-risk prostate cancer may balance transplant benefits with manageable oncologic risk.
Ridwan Alam, MD, Assistant Professor of Urology at Northwestern Medicine
Hiten Patel, MD, Assistant Professor of Urology at Northwestern Medicine
Kent Perry, Jr., MD, Associate Professor of Urology at Northwestern Medicine
Ashley Ross, MD, PhD, Professor of Urology at Northwestern Medicine

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