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Soin, Simal
(2001).
DOI: https://doi.org/10.21954/ou.ro.0000fcf8
Abstract
A side-effect of immunosuppression following renal transplantation is the development of skin infections and non-melanoma skin cancers which are associated with human papillomavirus (HPV) infection and sun exposure. Heart-lung transplant recipients are on average younger than renal allograft recipients and also receive a higher level of immunosuppressive therapy. To ascertain the incidence of HPV-associated cutaneous complications after heart and lung transplantation and the role of potential risk factors, we have investigated 397 of the surviving transplant recipients by means of questionnaire, review of medical records, and a proportion by interview and examination.
A high incidence of warts and non-melanoma skin cancers was found in heart-lung and heart transplant population studied in accordance with previous studies on renal transplant recipients. These skin complications of immunosuppression, especially warts, keratoses and cancers, were present in 249 patients (62.7%). Skin cancer was present in 17.6% of transplant recipients, all of whom were 5 or more years post-transplant. The squamousibasal cell carcinoma ratio was 8:1. HPV DNA was detected in 13 of 31 SCC samples analysed. In 6 cases, the HPV was HPV 20. 86% of the patients with skin cancers had high levels of lifetime occupational or social sun exposure.
Sun exposure, male gender and increasing graft survival time have emerged as major risk factors with minor influences from age and level of immunosuppression. No HI_A associations were found in the patients with malignancy in contrast to observations in kidney transplant patients.
Warts were found in 33.8% of patients, with a significantly higher incidence in males than in females, but were not influenced by levels of sun exposure.
CORE (COnnecting REpositories)
CORE (COnnecting REpositories)
