Skin Cancer after Organ Transplantation pp 391-404

Part of the Cancer Treatment and Research book series (CTAR, volume 146)

| Cite as

Pretransplantation Dermatologic Screening and Prophylaxis

  • Clark C. Otley
Chapter

In the United States, more than 29,000 patients receive solid organ transplants annually, and the number worldwide is many times higher. Organ transplantation offers increased quality of life and prolongs survival for hundreds of thousands of patients with debilitating end-stage organ disease. This “gift of life” is possible with potent systemic immunosuppression, which prevents post-transplant immunological rejection of the donor allograft. However, the immunosuppression is not specific for prevention of allograft rejection, and many adverse effects accrue with prolonged survival. Primary among these is skin cancer, the most common malignancy of solid organ transplant recipients.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Thompson SC, Jolley D, Marks R. Reduction of solar keratoses by regular sunscreen use. N Engl J Med 1993; 329:1147–51.PubMedCrossRefGoogle Scholar
  2. 2.
    Darlington S, Williams G, Neale R, et al. A randomized controlled trial to assess sunscreen application and beta carotene supplementation in the prevention of solar keratoses. Arch Dermatol 2003; 139:451–5.PubMedCrossRefGoogle Scholar
  3. 3.
    Green A, Williams G, Neale R, et al. Daily sunscreen application and betacarotene supplementation in prevention of basal-cell and squamous-cell carcinomas of the skin: a randomised controlled trial. Lancet 1999; 354:723–9.PubMedCrossRefGoogle Scholar
  4. 4.
    European best practice guidelines for renal transplantation. Section IV: Long-term management of the transplant recipient. IV.6.2. Cancer risk after renal transplantation. Skin cancers: prevention and treatment. Nephrol Dial Transplant 2002; 17(Suppl 4):31–6.Google Scholar
  5. 5.
    Le Mire L, Hollowood K, Gray D, et al. Melanomas in renal transplant recipients. Br J Dermatol 2006; 154:472–7.PubMedCrossRefGoogle Scholar
  6. 6.
    Ismail F, Mitchell L, Casabonne D, et al. Specialist dermatology clinics for organ transplant recipients significantly improves compliance with photoprotection and levels of skin cancer awareness. Br J Dermatol 2006; 155:916–25.PubMedCrossRefGoogle Scholar
  7. 7.
    Berg D, Otley CC. Skin cancer in organ transplant recipients: epidemiology, pathogenesis, and management. J Am Acad Dermatol 2002; 47:1–17.PubMedCrossRefGoogle Scholar
  8. 8.
    Herrero JI, Espana A, Quiroga J, et al. Nonmelanoma skin cancer after liver transplantation: study of risk factors. Liver Transplant 2005; 11:1100–6.CrossRefGoogle Scholar
  9. 9.
    Euvrard S, Kanitakis J, Decullier E, et al. Subsequent skin cancers in kidney and heart transplant recipients after the first squamous cell carcinoma. Transplantation 2006; 81: 1093–100.PubMedCrossRefGoogle Scholar
  10. 10.
    Moosa MR, Gralla J. Skin cancer in renal allograft recipients: experience in different ethnic groups residing in the same geographical region. Clin Transplant 2005; 19:735–41.PubMedGoogle Scholar
  11. 11.
    Otley CC, Cherikh WS, Salasche SJ, et al. Skin cancer in organ transplant recipients: effect of pretransplant end-organ disease. J Am Acad Dermatol 2005; 53:783–90.PubMedCrossRefGoogle Scholar
  12. 12.
    Saigal S, Norris S, Muiesan P, et al. Evidence of differential risk for posttransplantation malignancy based on pretransplantation cause in patients undergoing liver transplantation. Liver Transplant 2002; 8:482–7.CrossRefGoogle Scholar
  13. 13.
    Otley CC. Organization of a specialty clinic to optimize the care of organ transplant recipients at risk for skin cancer. Dermatol Surg 2000; 26:709–12.PubMedCrossRefGoogle Scholar
  14. 14.
    de Graaf YG, Kennedy C, Wolterbeek R, et al. Photodynamic therapy does not prevent cutaneous squamous-cell carcinoma in organ-transplant recipients: results of a randomized-controlled trial. J Invest Dermatol 2006; 126:569–74.PubMedCrossRefGoogle Scholar
  15. 15.
    Dragieva G, Prinz BM, Hafner J, et al. A randomized controlled clinical trial of topical photodynamic therapy with methyl aminolaevulinate in the treatment of actinic keratoses in transplant recipients. Br J Dermatol 2004; 151:196–200.PubMedCrossRefGoogle Scholar
  16. 16.
    Wulf HC, Pavel S, Stender I, et al. Topical photodynamic therapy for prevention of new skin lesions in renal transplant recipients. Acta Dermatol Venereol 2006; 86:25–8.Google Scholar
  17. 17.
    Brown VL, Atkins CL, Ghali L, et al. Safety and efficacy of 5% imiquimod cream for the treatment of skin dysplasia in high-risk renal transplant recipients: randomized, double-blind, placebo-controlled trial. Arch Dermatol 2005; 141:985–93.PubMedCrossRefGoogle Scholar
  18. 18.
    Carbone PP, Pirsch JD, Thomas JP, et al. Phase I chemoprevention study of difluoromethylornithine in subjects with organ transplants. Cancer Epidemiol Biomarkers Prev 2001; 10:657–61.PubMedGoogle Scholar
  19. 19.
    Oseroff A. PDT as a cytotoxic agent and biological response modifier: Implications for cancer prevention and treatment in immunosuppressed and immunocompetent patients. J Invest Dermatol 2006; 126:542–4.PubMedCrossRefGoogle Scholar
  20. 20.
    Cowen EW, Billingsley EM. Awareness of skin cancer by kidney transplant patients. J Am Acad Dermatol 1999; 40:697–701.PubMedCrossRefGoogle Scholar
  21. 21.
    Szepietowski JC, Reich A, Nowicka D, et al. Sun protection in renal transplant recipients: urgent need for education. Dermatology 2005; 211:93–7.PubMedCrossRefGoogle Scholar
  22. 22.
    Robinson JK, Rigel DS. Sun protection attitudes and behaviors of solid-organ transplant recipients. Dermatol Surg 2004; 30:610–5.PubMedCrossRefGoogle Scholar
  23. 23.
    Moloney FJ, Almarzouqi E, O’Kelly P, et al. Sunscreen use before and after transplantation and assessment of risk factors associated with skin cancer development in renal transplant recipients. Arch Dermatol 2005; 141:978–82.PubMedCrossRefGoogle Scholar
  24. 24.
    Clowers-Webb HE, Christenson LJ, Phillips PK, et al. Educational outcomes regarding skin cancer in organ transplant recipients: Randomized intervention of intensive vs. standard education. Arch Dermatol 2006; 142:712–8.Google Scholar
  25. 25.
    Tavadia S, Dawn G, Payne C, et al. Skin-cancer awareness in Scottish cardiac transplant recipients. Clin Exp Dermatol 2006; 31:354–7.PubMedCrossRefGoogle Scholar
  26. 26.
    AT-RISC.org [homepage on the Internet]. After Transplantation–Reduce Incidence of Skin Cancer. Available from: http://www.at-risc.org/ Accessed: October 1, 2006.
  27. 27.
    Otley CC, Berg D, Ulrich C, et al. Reduction of immunosuppression for transplant-associated skin cancer: expert consensus survey. Br J Dermatol 2006; 154:395–400.PubMedCrossRefGoogle Scholar
  28. 28.
    Kauffman HM, Cherikh WS, Cheng Y, et al. Maintenance immunosuppression with target-of-rapamycin inhibitors is associated with a reduced incidence of de novo malignancies. Transplantation 2005; 80:883–9.PubMedCrossRefGoogle Scholar
  29. 29.
    Kahan BD, Knight R, Schoenberg L, et al. Ten years of sirolimus therapy for human renal transplantation: the University of Texas at Houston experience. Transplant Proc 2003; 35(Suppl):25S–34S.PubMedCrossRefGoogle Scholar
  30. 30.
    Mathew T, Kreis H, Friend P. Two-year incidence of malignancy in sirolimus-treated renal transplant recipients: results from five multicenter studies. Clin Transplant 2004; 18:446–9.PubMedCrossRefGoogle Scholar
  31. 31.
    Christenson LJ, Geusau A, Ferrandiz C, et al. Specialty clinics for the dermatologic care of solid-organ transplant recipients. Dermatol Surg 2004; 30:598–603.PubMedCrossRefGoogle Scholar
  32. 32.
    Reece SM, Harden PN, Smith AG, et al. A model for nurse-led skin cancer surveillance following renal transplantation. Nephrol Nurs J 2002; 29:257–9, 267.PubMedGoogle Scholar
  33. 33.
    Penn I. The effect of immunosuppression on pre-existing cancers. Transplantation 1993; 55:742–7.PubMedCrossRefGoogle Scholar
  34. 34.
    Otley CC, Hirose R, Salasche SJ. Skin cancer as a contraindication to organ transplantation. Am J Transplant 2005; 5:2079–84.PubMedCrossRefGoogle Scholar
  35. 35.
    Marcil I, Stern RS. Risk of developing a subsequent nonmelanoma skin cancer in patients with a history of nonmelanoma skin cancer: a critical review of the literature and meta-analysis. Arch Dermatol 2000; 136:1524–30.PubMedCrossRefGoogle Scholar
  36. 36.
    Chuang TY, Popescu NA, Su WP, et al. Squamous cell carcinoma. A population-based incidence study in Rochester, Minn. Arch Dermatol 1990; 126:185–8.PubMedCrossRefGoogle Scholar
  37. 37.
    Johnson TM, Rowe DE, Nelson BR, et al. Squamous cell carcinoma of the skin (excluding lip and oral mucosa). J Am Acad Dermatol 1992; 26:467–84.PubMedCrossRefGoogle Scholar
  38. 38.
    Martinez JC, Otley CC, Stasko T, et al. Defining the clinical course of metastatic skin cancer in organ transplant recipients: a multicenter collaborative study. Arch Dermatol 2003; 139:301–6.PubMedCrossRefGoogle Scholar
  39. 39.
    Balch CM, Buzaid AC, Soong SJ, et al. Final version of the American Joint Committee on Cancer staging system for cutaneous melanoma. J Clin Oncol 2001; 19:3635–48.PubMedGoogle Scholar
  40. 40.
    Balch CM, Soong SJ, Gershenwald JE, et al. Prognostic factors analysis of 17,600 melanoma patients: validation of the American Joint Committee on Cancer melanoma staging system. J Clin Oncol 2001; 19:3622–34.PubMedGoogle Scholar
  41. 41.
    Penn I. Malignant melanoma in organ allograft recipients. Transplantation 1996; 61:274–8.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Clark C. Otley
    • 1
  1. 1.Mayo Clinic College of Medicine, Chair, Division of Dermatologic Surgery, Department of Dermatology, Mayo ClinicRochesterUSA

Personalised recommendations