Backgrounds. Incidences of skin cancer and solid tumor among solid organ transplant recipients are significantly higher than those of immunocompetent persons. Nonmelanoma skin cancer (NMSC), especially squamous or basal cell carcinomas, comprised about 95% of skin cancer. NMSC is treatable, however, its association to solid tumor has been poorly understood.

Materials and Methods. During 2000-2009, patients who received solid organ transplant (tx) were included in this study. Inclusion criteria were: adult recipients (age>20yrs); graft survival >1 yr; no multiple organs; and primary tx. A total number of patients selected were 116,884 for kidney transplant alone (KTA), 38,408 liver transplant alone (LTA), 14,857 heart transplant alone (HTA), and 9,452 lung transplant alone (LuTA) from OPTN/UNOS data as of July 31, 2012. Patients were divided into 2 groups: (1) G1-patients with NMSC and (2) G2-patients without NMSC.

Results. We identified 4,037 de novo solid tumors among KTA recipients, 1,860 LTA, 1,043 HTA, and 659 LuTA. Incidences of solid tumor were 9.36% in G1 vs 3.25% G2 (P<0.001) for KTA; 10.42% G1 vs 4.51% G2 in LTA (P<0.001); 14.40% G1 vs 6.08% G2 in HTA (P<0.001); and 11.55% G1 vs 6.97% G2 in LuTA (P<0.001) (figure). Median times to diagnose solid tumor in G1 were significantly longer than those of G2 for all solid organ transplantations: 1574 days for G1 vs 1247 days G2 in KTA, P<0.001; 1377 vs 1110 LTA, P<0.001; 1573 vs 1401 HTA; and 1124 vs 1028 LuTA, P<0.001 (table).

Conclusions. There exist significant association between post-transplant nonmelanoma skin cancer and solid tumor after solid organ transplantation. Careful monitoring regarding skin cancer is necessary after solid organ transplantation.

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