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- W4366088086 abstract "Solid organ transplant recipients are at increased risk of epithelial skin cancer and melanoma. The immunosuppression used to prevent allograft rejection may be the source of this risk via decreased immunosurveillance. The composition and duration of immunosuppression are independent risk factors for the development of malignancy in these patients. The purpose of this study is to evaluate these regimen differences. The TriNetX Research Network was used for this study, providing access to anonymized medical record information for more than 95 million patients in 75 healthcare organizations. All patients were prohibited from having a diagnosis of melanoma or nonmelanoma skin cancer prior to solid organ transplant, identified by International Classification of Disease (ICD-10) codes C43 and C44. Cohorts were separately created for patients with lung, heart, liver, and kidney transplants by their respective Current Procedural Terminology (CPT) codes. Relative risks for melanoma and nonmelanoma skin cancers were identified for each cohort, and the cohorts were separately analyzed for the respective utilization rates of immunosuppressant medications. As compared to a non-transplant control group, the relative risk of nonmelanoma skin cancer was 17x for lung, 12x for heart, 11x for liver, and 9x for kidney transplant recipients. Lower doses of tacrolimus were associated with higher risk of skin cancer, as higher doses are used postoperatively and subsequently tapered. Each organ cohort had similar utilization rates of tacrolimus, mycophenolate, and cyclosporine. Azathioprine was used in 39% of lung transplants, 11% of heart, 14% of liver, and 7% of kidney transplant patients. This pattern most closely resembled the differences in relative risk between the cohorts. In solid organ transplant patients, nonmelanoma skin cancer risk varies by the type of organ transplanted, and more specifically by the postoperative immunosuppression regimen utilized. It appears that azathioprine may be the most significant contributor to the difference in cancer risk in these patients." @default.
- W4366088086 created "2023-04-19" @default.
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- W4366088086 date "2023-05-01" @default.
- W4366088086 modified "2023-10-16" @default.
- W4366088086 title "314 Skin cancer risk differences in solid organ transplant patients: Is one medication responsible?" @default.
- W4366088086 doi "https://doi.org/10.1016/j.jid.2023.03.318" @default.
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