Importance Skin cancer is the most common malignancy affecting solid organ transplant recipients (SOTR). Transplant recipients have a significantly increased risk for developing both melanoma and nonmelanoma skin cancers compared to the general population.

Objective To form an expert panel of US dermatologists and transplant physicians to conduct Delphi-method surveys in order to establish standardized, consensus screening recommendations for SOTR in the US.

Methods Three rounds of surveys were emailed to panelists. Data from completed surveys was analyzed and compiled into summary reports which were then redistributed to the panel after each round. Data from a recent publication about epidemiologic incidence of skin cancer and risk factors in SOTR was included for review prior to completing the final survey. Consensus was set a priori to be 80% agreement of experts.

Findings 84 expert panelists completed all three rounds of the Delphi surveys. Panelists agreed that patients should be risk assessed by the transplant team to identify potential need for screening. Panelists reached consensus on the need for an evidence-based risk assessment tool that is time-efficient and can be completed by office staff. Panelists agreed that a dermatologist should perform screening. All Caucasian, Asian, Hispanic, and high risk African American patients should be screened within 5 years after transplant. High risk Caucasian patients should be screened within 2 years after transplant. No consensus was reached for low risk African American SOTR. All SOTR with a history of skin cancer should continue follow-up standard of care for skin cancer surveillance.

Conclusions and Relevance We propose a standard approach to skin cancer screening in SOTR based on consensus of experts in the fields of dermatology and transplant medicine. Future directions will include development of a risk stratification tool to guide dermatology referral for skin cancer screening.

CITATION INFORMATION: Crow L., Arron S., Chung C., Jambusaria-Pahlajani A., Lowenstein S., On behalf of the Transplant Skin Cancer Network Development of an Expert Consensus Guideline for Skin Cancer Screening in Solid Organ Transplant Recipients Am J Transplant. 2017;17 (suppl 3).

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