Kidney Transplantation Increases Melanoma Risk

Individuals who receive a renal transplantation have a greater risk of developing melanoma after surgery, according to a recent study. This risk is highest in older men, white transplant recipients, living donors, and recipients of sirolimus therapy and/or cyclosporine therapy.

The researchers evaluated a cohort of 105,174 patients with a mean age of 49.6 years who received a renal transplant between 2004 and 2012. Patient data was obtained through the US Renal Data System (USRDS) from 2015 to 2016.
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During the study, the researchers assessed differences in baseline characteristics between those who did and did not develop melanoma post-transplant, and then conducted a survival analysis. Included in the study were renal transplant recipients who had received a diagnosis of melanoma according to any inpatient or outpatient claim associated with a billing code for melanoma. However, patients with a history of pre-transplant melanoma, previous kidney transplantation, or transplantation before 2004 or after 2014 were excluded.

Results indicated that 488 (0.4%) patients had developed melanoma after a renal transplantation. According to the survival analysis, significant risk factors for developing melanoma included older age, male sex, white race, having less than 4 human leukocyte antigen mismatches, being a living donor, and receiving sirolimus therapy and/or cyclosporine therapy.

The age-standardized relative rate of melanoma was 4.9 among USRDS patients, compared with Surveillance, Epidemiology, and End Results patients across all years. Median time to melanoma in patients who had developed the disease was 1.45 years, according to a Kaplan-Meier estimate.

“Renal transplant recipients had greater risk of developing melanoma than the general population,” the researchers concluded. “We believe that the risk factors we identified can guide clinicians in providing adequate care for patients in this vulnerable group.”

—Christina Vogt

Reference:

Ascha M, Ascha MS, Tanenbaum J, Bordeaux JS. Risk factors for melanoma in renal transplant recipients [Published online July 26, 2017]. JAMA Dermatol. doi:10.1001/jamadermatol.2017.2291.