Skin cancers and their precursors in Finnish liver transplantation recipients: A follow-up study

BackgroundThe incidence of skin cancers in transplant recipients is known to have increased compared to the general population. Risk factors include age at the time of transplantation, duration and dose of immunosuppressive medication. Research data on the incidence of skin cancer precursors in transplant recipients is limited.ObjectivesWe aimed to investigate the incidence of skin cancers and their precursors and the factors influencing their development in Finnish liver transplant recipients.MethodsWe recruited 140 volunteers who were over 18 years old at the time of the study and had been transplanted at least 5 years before. Patients were examined by a dermatologist between 2012 and 2016 and, if necessary, followed up based on cutaneous findings. All patients in the study were followed up until May 2021 or until the death of the patient, based on medical records.ResultsThe study found an increased incidence of nonmelanoma skin cancers (NMSCs), especially of squamous cell carcinoma, in liver transplantation (LT) recipients compared to the general Finnish population (squamous cell carcinoma SIR 21.2, basal cell carcinoma SIR 7.6). Precursors of squamous cell carcinoma were found in 43 patients (30.7%) after transplantation. The study found no statistically significant difference between the drugs used for immunosuppression.ConclusionsOur data showed an increased risk of NMSCs in LT recipients. After LT, patients are at significant risk of SCC and its precursors may be found even in almost third of patients in 17.5 years follow-up. Given this information, it is considered important to monitor LTRs with adequate frequency to treat precursors as early as possible before the development of SCC.