25.0: Thursday, March 17, 2005

Skin Cancers in Transplant Recipients

Susan Gannon, MD, Joseph Thornton, MD, and Joshua A. King, MD.

Skin Cancers in Organ Transplant Recipients

As the number of organ transplants recipients and their long-term survival increase, so do the complications of lifelong immunosuppressive therapy. The development of various internal and cutaneous malignancies is a well-known sequel of immune modulation. Skin cancer is the most common cancer affecting transplant recipients. The incidence of these cancers increases with the length of therapy, ultimately affecting 50 percent or more of white transplant patients. In contrast to the general population, skin malignancies in transplant recipients tend to be multiple, aggressive, recurrent, and metastatic. Although, typically a manageable problem, for some transplant recipients they cause substantial morbidity and even mortality.

The aggressive nature of these tumors was recently witnessed during the care of a cardiac transplant recipient. A subsequent review of transplant patients undergoing care for non-melanoma skin cancers at the Albany Medical Center and Stratton VA Medical Center, stimulated concern for the care and treatment of these high-risk patients. The coordination of both medical and surgical specialist is required to reduce the morbidity and mortality associated with these cancers. The purpose of this article is to review the characteristics, presentation, management, and prevention of non-melanoma skin carcinomas in transplant recipients.