By Gary M. White, MD
Organ transplant patients are at greater risk for both infections and the development of malignancies.
- Immunosuppressed organ transplant recipients have an 80-fold increased risk of squamous cell carcinoma (SCC) and a 16-fold increased risk of basal cell carcinoma (BCC).
- Voriconazole in transplant patients can greatly increase the risk of SCC.
- Switching to sirolimus in a transplant patient who has developed cancer (skin or otherwise) decreases the risk of developing subsequent skin cancer [JAMA Derm 2016;152;533].
Lung transplant patients tend to receive more overall immune suppression than other solid-organ transplant recipients. In one study of 166 lung transplant patients [JAAD 2015;72;92], nearly half (47%) had developed a new skin cancer within 10 years after lung transplantation. SCC was the most common. Risk factors included prior history of skin cancer, older age, and male gender. In one study from UCSF, voriconazole increased the risk of SCC by 73% in lung transplant patients [Dermatology News, May 2015 p.10].
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