Background: Cutaneous malignancy is a major cause of morbidity in recipient
s.
Objective: Our purpose was to report on skin cancer in Australian heart tra
nsplant recipients with analysis of HLA factors.
Methods: We reviewed histologically proven skin cancers in the first 455 pa
tients undergoing organ transplantation in Sydney, Australia.
Results: The cumulative incidence of skin cancer was 31% at 5 years and 43%
at 10 years with a squamous cell carcinoma/basal cell carcinoma ratio of 3
:1. Caucasian origin, increasing age at transplantation, and duration of fo
llow-up were significantly associated with skin cancer. Skin cancer account
ed for 27% of 41 deaths occurring after the fourth year. Recipient HLA-DR h
omozygosity was associated with skin cancer overall, whereas HLA-DR7 was a
protective factor in skin cancer overall, squamous cell carcinoma, and Bowe
n's disease. HLA-A1 and HLA-A11 were significant protective factors in Bowe
n's disease.
Conclusion: Skin cancer is a major cause of morbidity and long-term mortali
ty in heart transplant patients.