Squamous and basal cell carcinoma in heart transplant recipients.
BACKGROUND
Cutaneous malignancies are frequent in organ transplant recipients. We retrospectively reviewed a large series of heart transplant recipients and report on the prevalence and risk factors for development of cutaneous squamous and basal cell carcinoma.


METHODS
Between Dec. 4, 1985, and Dec. 27, 1996, 299 heart transplantations were performed at the Oregon Health Sciences University. Heart transplant recipients with more than 6 months survival or follow-up were investigated for squamous and basal cell carcinoma (n = 248).


RESULTS
Forty-one patients (17%) were found to have 192 squamous or basal cell carcinomas. Squamous cell carcinoma was the predominate skin malignancy, constituting 172 (90%) of the lesions. The mean number of skin malignancies per patient was 4.7 +/- 0.81 (range 125). Patients with development of a skin malignancy were 8 years older on average, with a male-to-female ratio of 19.5:1. The predominant skin type and eye color were fair (59%) and blue (59%), respectively. Cumulative risk, based on actuarial survival analysis for development of a squamous or basal cell carcinoma at 1 year, was 3% and increased to 21% and 35% at 5 and 10 years, respectively. In addition, cumulative risk increased in patients who received treatment with OKT3.


CONCLUSIONS
Cumulative risk of development of a skin malignancy increased with time and use of OKT3. Additional patient risk factors included older age, male sex, fair skin, and blue eyes.
Lampros
T D
TD
Division of Cardiopulmonary Surgery and the Oregon Heart Transplant Programs, Oregon Health Sciences University, Portland 97201-3098, USA.
Cobanoglu
A
A
Parker
F
F
Ratkovec
R
R
Norman
D J
DJ
Hershberger
R
R
D000206:Actuarial Analysis; D002280:Basal Cell Carcinoma / Q000209:etiology*; D002294:Carcinoma, Squamous Cell / Q000209:etiology*; D005260:Female; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D016853:Muromonab-CD3 / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors; D012878:Skin Neoplasms / Q000209:etiology*
D007166:Immunosuppressive Agents; D016853:Muromonab-CD3