Initial Skin Cancer Screening for Solid Organ Transplant Recipients in the United States

Published 10 September 2019

Lauren D. Crow, Anokhi Jambusaria-Pahlajani, Christina L. Chung, David A. Baran, Stefan E. Lowenstein, Mark Abdelmalek, Rehana L. Ahmed, Milan J. Anadkat, Selim M. Arcasoy, Daniel Berg, Kristin P. Bibee, Elizabeth Billingsley, William H. Black, Travis W. Blalock, Melissa Bleicher, Daniel C. Brennan, David G. Brodland, Mariah R. Brown, Bryan T. Carroll, John A. Carucci, Timothy W. Chang, George Chaux, Carrie Ann Cusack, Daniel F. Dilling, Alden Doyle, Amir M. Emtiazjoo, Nkanyezi H. Ferguson, Scott W. Fosko, Matthew C. Fox, Simin Goral, Alice L. Gray, John R. Griffin, Ramsey R. Hachem, Shelley A. Hall, Allison M. Hanlon, Don Hayes Jr, Gavin W. Hickey, Jonathan Holtz, Robert Samuel Hopkins, Jenny Hu, Conway C. Huang, Shang I. Brian Jiang, Siddhartha G. Kapnadak, Edward S. Kraus, Erika D. Lease, Nicolae Leca, James C. Lee, Justin J. Leitenberger, Mary Ann Lim, Maria I. Longo, Shahid M. Malik, Jorge M. Mallea, Alan Menter, Sarah A. Myers, Marcy Neuburg, Rajiv I. Nijhawan, Douglas J. Norman, Clark C. Otley, So Yeon Paek, Amit D. Parulekar, Manisha J. Patel, Vishal Anil Patel, Timothy J. Patton, Melissa Pugliano-Mauro, Karthik Ranganna, Ashwin K. Ravichandran, Rachel Redenius, Garrett R. Roll, Faramarz H. Samie, Thuzar Shin, Jonathan P. Singer, Pooja Singh, Seaver L. Soon, Teresa Soriano, Ronald Squires, Thomas Stasko, Jennifer A. Stein, Sandra J. Taler, Norah A. Terrault, Christie P. Thomas, Sofya Tokman, Rade Tomic, Amanda R. Twigg, Mark A. Wigger, Nathalie C. Zeitouni, Sarah T. Arron

Transpl Int. 2019 Sep

• Advanced Heart Failure & Transplantation
• Advanced Lung Failure & Transplantation
• Cardiology
• Consensus Document
• Endorsement
• Publications & Journals
• Pulmonology
• Standards & Guidelines

Skin cancer is the most common malignancy affecting solid organ transplant recipients (SOTR), and SOTR experience increased skin cancer-associated morbidity and mortality. There are no formal multidisciplinary guidelines for skin cancer screening after transplant, and current practices are widely variable. These guidelines prioritize and emphasize the need for screening for SOTR at greatest risk for skin cancer.

A panel of 84 U.S. dermatologists and transplant physicians conducted three rounds of Delphi method surveys to establish skin cancer screening recommendations for SOTR. Findings include:

• The transplant team should risk stratify SOTR for screening, and dermatologists should perform skin cancer screening by full-body skin examination.
• SOTR with a history of skin cancer should continue regular follow-up with dermatology for skin cancer surveillance. High-risk transplant patients include thoracic organ recipients, SOTR age 50 and above, and male SOTR.
• High-risk Caucasian patients should be screened within 2 years after transplant, all Caucasian, Asian, Hispanic, and high-risk African American patients should be screened within 5 years after transplant.
• No consensus was reached regarding screening for low-risk African American SOTR.
• A standardized approach to skin cancer screening in SOTR based on multidisciplinary expert consensus is proposed.

This document was endorsed by ISHLT in 2019.