Heart transplants increase risk for skin cancer
MedWire News: People who receive heart transplants face a surprising complication - a hugely increased risk for developing and dying from skin cancer.
The findings are reported by US scientists, who suggest that heart-transplant patients should be closely monitored for signs of skin cancer following their life-saving surgery.
Heart transplantation is a "last resort" treatment for patients whose hearts are badly damaged by disease. The first heart transplant was performed in 1967; today, around 3500 such transplants are performed worldwide each year.
As the number of people with a heart transplant has increased, scientists have learnt more about the pros and cons of the surgery. Recently, it has become apparent that heart transplant recipients may face an increased likelihood for developing skin cancer.
The specific nature and causes of this risk were investigated in a study by Murad Alam (Northwestern University, Chicago, Illinois) and colleagues, who obtained information about more than 6000 heart transplants performed in the USA between 1990 and 2008.
The study - the largest in the field to date - found that the two major forms of skin cancer, known as melanoma and non-melanoma, were much more common in people who had received a heart transplant than in the general population.
By 10 years post-transplantation, 15% of the patients had developed skin cancer. Certain groups - specifically, White (Caucasian) people, men, and older people - were particularly prone to developing skin cancer.
Overall, the risk for developing skin cancer following a heart transplant was increased by between four and 30 times, as compared with people of the same gender and age in the general US population.
The risk was highest for a type of skin cancer known as "cutaneous squamous cell carcinoma," which is usually associated with sun exposure. However, the risk for dying was highest for another type of skin cancer, known as "melanoma."
Concluding their report in the American Journal of Transplantation, Alam and fellow researchers say that skin cancer in transplant patients may be related to their use of "immunosuppressive" medications.
These drugs are important after heart transplantation to stop the body rejecting the donated organ; however, they can also cause changes to the body's natural defenses, possibly making them more susceptible to developing cancer.
The researchers say that while the benefits of heart transplantation continue to outweigh the risks, people who receive a donor heart should be regularly examined by a dermatologist, in order to identify suspicious lesions at an early stage, when they are most easily treated.
MedWire (www.medwire-news.md) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011
By Joanna Lyford