Skin neoplasia in kidney transplant candidates and recipients — new perspectives

Abstract

Kidney transplantation (KT) in chronic kidney disease
is the best method of renal replacement therapy. KT
prolongs the patient’s life by decades, but the risk
of getting cancer is much higher than in the general
population. Cancer is listed as the second, after cardiovascular
disease, cause of death after KT; it also
causes death of many other solid organ transplant
recipients (SOTRs). Skin cancers are the most common
tumors in SOTRs. Treatment of these patients
is very complex due to immunosuppression and
requires cooperation of specialists in many fields
depending on the transplanted organ and the type
of neoplastic disease. The most frequent cancers are
squamous cell carcinoma (SCC), basal cell carcinoma
(BCC), malignant melanoma (MM), Merkel cell
carcinoma (MCC), and much less frequent — skin
lymphomas. Common risk factors include chronic
exposure to ultraviolet (UV) radiation, HPV, EBV infection,
pretransplant skin cancer, older age at transplantation,
Caucasian origin, male sex, and type of
immunosuppression. Multidisciplinary cooperation
of dermatologists, transplant nephrologists, oncologists,
hematologists, and other health professionals
is needed for appropriate medical care.
This article focuses on epidemiology, risk factors of
skin neoplasia, and eligibility of patients with previous
skin cancer and lymphoma for kidney transplants.
The possibility of administering immunotherapy
in transplant recipients with recurrentmentioned