title: Melanoma Outcomes in Transplant Recipients With Pretransplant Melanoma.
abstract: BACKGROUND
  There are limited data on outcomes in transplant recipients with a history of pretransplant melanoma.
  
  
  OBJECTIVE
  To determine whether pretransplant melanoma is associated with differences in survival or posttransplant melanoma risk.
  
  
  METHODS
  We evaluated the outcomes of 185,039 US transplant recipients from the Transplant Cancer Match Study. We also evaluated the impact of transplantation on 141,441 patients with melanoma identified in cancer registries.
  
  
  RESULTS
  There were 336 transplant recipients (0.18%) with pretransplant melanoma; they had increased risk of melanoma-specific mortality (hazard ratio [HR], 27; 95% confidence interval [CI], 11-64, p < .0001), overall mortality (HR, 1.3; 95% CI, 1.0-1.5, p = .02), and incident melanoma (HR, 5.4; 95% CI, 2.9-9.8, p < .0001) after transplant, compared with recipients without pretransplant melanoma. The 10-year absolute risk difference was 2.97% for melanoma-specific mortality, 3.68% for incident melanoma, and 14.32% for overall mortality. Among the 141,441 patients with melanoma in the general population, 68 (0.05%) subsequently received a transplant. Transplantation increased melanoma-specific mortality, but not significantly (HR, 1.7; 95% CI, 0.61-4.5, p = .32).
  
  
  CONCLUSIONS
  Pretransplant melanoma is associated with increased melanoma-specific mortality, overall mortality, and incident melanoma after transplant. Nonetheless, the rarity of melanoma-related events supports the current practice for listing transplant candidates with a history of melanoma.
authors.affiliation: *Department of Dermatology University of California, San Francisco, San Francisco, California; †Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland; ‡Information Management Services, Rockville, Maryland; §Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, California; ‖Cancer Prevention Institute of California, Fremont, California; ¶Rutgers School of Public Health, Piscataway, New Jersey; #Cancer Epidemiology Services, New Jersey Department of Health, Trenton, New Jersey.
authors.forename: Sarah T
authors.initials: ST
authors.lastname: Arron
authors.forename: Amanda K
authors.initials: AK
authors.lastname: Raymond
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: Yanik
authors.forename: David
authors.initials: D
authors.lastname: Castenson
authors.forename: Charles E
authors.initials: CE
authors.lastname: McCulloch
authors.forename: Christina A
authors.initials: CA
authors.lastname: Clarke
authors.forename: Lisa E
authors.initials: LE
authors.lastname: Paddock
authors.forename: Xiaoling
authors.initials: X
authors.lastname: Niu
authors.forename: Eric A
authors.initials: EA
authors.lastname: Engels
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D006801:Humans; D008545:Melanoma / Q000401:mortality*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis; D016609:Neoplasms, Second Primary / Q000175:diagnosis; D012307:Risk Factors; D012878:Skin Neoplasms / Q000401:mortality*; D066027:Transplant Recipients; D055815:Young Adult
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