The incidence of non-melanoma skin cancer and post-transplant lympho-proliferative disorders in the Scottish cardiac transplant population and the provision of specialist dermatological follow-up

Scottish Medical Journal
Iain McPherson, Alan Kirk

Abstract

Background Immunosuppression helps prevent acute rejection post-cardiac transplant but has been linked to malignancy development. This may be due to a reduction in T-lymphocyte function, a direct oncogenic effect or the increased impact of environmental carcinogens. There has been shown to be significant increases in non-melanoma skin cancers and post-transplant lympho-proliferative disorders, particularly in those treated with OKT3. Aim To investigate the survival and incidence of malignancy in the Scottish cardiac transplant population and whether rates of non-melanoma skin cancers justify the provision of specialist dermatological follow-up. Methods and results Retrospective case note analysis of patients transplanted (363) or followed up (2) in Scotland from 1992 to 2016. Kaplan-Meier survival analysis generated a survival curve. Patients had a 1-year survival of 82% and a median survival of 10.9 years. There were 60 (95% CI 47.5, 75.2) NMSCs and 8 (3.7, 12.4) post-transplant lympho-proliferative disorders diagnosed in the cohort (3110 person years follow-up). Fisher's exact test was employed to analyse the association between induction therapy (via OKT3 or rabbit antithymocyte globulin) and post-transplant lympho-prolifera...Continue Reading

References

Jun 3, 1967·Lancet·F M Burnet
Feb 21, 2004·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Gerhard Opelz, Bernd Döhler
Jun 24, 2006·The Oncologist·Ann S LaCasce
Aug 3, 2007·Interactive Cardiovascular and Thoracic Surgery·Michel HaddadRoy G Masters
Dec 23, 2009·Archives of Dermatology·Jerry D BrewerClark C Otley
Sep 4, 2010·Acta Dermato-venereologica·Annette Ostergaard JensenHenrik Toft Sørensen
Jul 3, 2013·Cold Spring Harbor Perspectives in Medicine·Jeremy R ChapmanGermaine Wong
Oct 27, 2015·World Journal of Gastroenterology : WJG·Daan Dierickx, Nina Cardinaels

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