Skin cancer after renal transplantation: Results of a multicenter study in Iran.
BACKGROUND
Incidence and risk factors for skin tumors following renal transplantation can vary geographically; therefore, a retrospective study was performed to determine the incidence of and potential risk factors for skin cancer at 14 Transplant Centers in Iran between 1984 and 2008.


METHODS
We enrolled 11,255 kidney transplant recipients who were examined for all skin tumors. All skin cancers were established by histological examination. The data collection included the patient's age and sex, immunosuppressive regimen before and after diagnosis of tumor, rejection episodes, post-transplant latency period, other concurrent neoplastic problems, renal allograft function and outcome.


RESULTS
One hundred and twenty-eight (1.14%) renal recipients had skin tumor, representing half of all post-transplant malignancies (128 out of 245 cases). Kaposi's sarcoma was the most common post-transplant cancer compared with other skin tumors. Male recipients had more tumors than did females (P=0.04); the male-to-female ratio in the affected patients was 2.5:1. The age at transplantation of patients with skin tumor was higher compared to RTRs without skin tumor (47±11 vs. 38±15 years, P=0.000), and individuals older than 45 years were at higher risk (odds ratio=3.8, 95%CI 2.6-5.5) of skin cancers. Patients consuming azathioprine were at risk more of skin cancer compared with those were on MMF (odds ratio =2.9, 95%, CI 2.0-4.2). The overall mortality was low (7.8%) in cases with skin cancer.


CONCLUSIONS
This study showed that male sex, increased age, prolonged immunosuppression and azathioprine increased the risk of skin tumors after renal transplantation.
Einollahi
Behzad
B
Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Nemati
Eghlim
E
Lessan-Pezeshki
Mahboob
M
Simforoosh
Naser
N
Nourbala
Mohammad Hossein
MH
Rostami
Zohreh
Z
Nafar
Mohsen
M
Pourfarziani
Vahid
V
Beiraghdar
Fatemeh
F
Mahdavi-Mazdeh
Mitra
M
Ahmadpour
Pedram
P
Makhdoomi
Khadijeh
K
Ghafari
Ali
A
Ardalan
Mohammad Reza
MR
Taebi Khosroshahi
Hamid
H
Oliaei
Farshid
F
Shahidi
Shahrzad
S
Makhlogh
Atehieh
A
Azmandian
Jalal
J
Samimagham
Hamid Reza
HR
Shabazian
Heshmatollah
H
D000367:Age Factors; D017668:Age of Onset; D001379:Azathioprine / Q000009:adverse effects; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D007166:Immunosuppressive Agents / Q000009:adverse effects; D015994:Incidence; D007492:Iran / Q000453:epidemiology; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000009:adverse effects / Q000031:analogs & derivatives; D009369:Neoplasms / Q000139:chemically induced / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D012514:Sarcoma, Kaposi / Q000150:complications / Q000453:epidemiology / Q000401:mortality; D017678:Sex Distribution; D012737:Sex Factors; D012878:Skin Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality
D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid; D001379:Azathioprine