By Peter Laird MD,
Solid organ transplants are a life saving gift especially when discussing heart, liver and lung transplants since there are no effective treatment alternatives once these organs pass sustainable function to maintain life. However, with all such medical treatments, they also come with their own unique risks. One such risk of solid organ transplant is a significant increase in skin cancers due to the immunosuppressive regimen.
Results In total, 312 heart transplant patients had 1395 new skin cancers in 2097 person-years (mean, 0.43 per year per patient) with a range of 0 to 306 for squamous cell carcinoma (SCC) and 0 to 17 for basal cell carcinoma (BCC). The cumulative incidence rates of any skin cancer were 20.4%, 37.5%, and 46.4% at 5, 10, and 15 years after heart transplant, respectively. Cumulative incidence of SCC after the first BCC was 98.1% within 7 years. Multivariate analysis showed that posttransplant nonskin cancer, increased age, and heart failure etiologic factors other than idiopathic disease were associated with increased risk of SCC. Posttransplant herpes simplex viral infection, increased age, and use of mycophenolate mofetil for immunosuppression were associated with increased risk of BCC.
Dr. Clark Otley of the Mayo clinic reviews the risks and treatment options.