Skin cancer in Australian heart transplant recipients.

Abstract

Cutaneous malignancy is a major cause of morbidity in organ transplant recipients. Our purpose was to report on skin cancer in Australian heart transplant recipients with analysis of HLA factors. We reviewed histologically proven skin cancers in the first 455 patients undergoing organ transplantation in Sydney, Australia. The cumulative incidence of skin cancer was 31% at 5 years and 43% at 10 years with a squamous cell carcinoma/basal cell carcinoma ratio of 3:1. Caucasian origin, increasing age at transplantation, and duration of follow-up were significantly associated with skin cancer. Skin cancer accounted for 27% of 41 deaths occurring after the fourth year. Recipient HLA-DR homozygosity was associated with skin cancer overall, whereas HLA-DR7 was a protective factor in skin cancer overall, squamous cell carcinoma, and Bowen's disease. HLA-A1 and HLA-A11 were significant protective factors in Bowen's disease. Skin cancer is a major cause of morbidity and long-term mortality in heart transplant patients.