Melanoma in Solid Organ Transplant Recipients

• Published in: American journal of transplantation Vol. 10; no. 5; pp. 1297 - 1304
• Main Authors: Zwald, F. O., Christenson, L. J., Billingsley, E. M., Zeitouni, N. C., Ratner, D., Bordeaux, J., Patel, M. J., Brown, M. D., Proby, C. M., Euvrard, S., Otley, C. C., Stasko, T.
• Format: Journal Article
• Language: English
• Published: Malden, USA Blackwell Publishing Inc 01.05.2010; Wiley
• Subjects: Biological and medical sciences; Dermatology; Humans; Immunosuppression Therapy; Male; Medical sciences; Melanoma; Melanoma - pathology; Melanoma - secondary; Melanoma - surgery; Plastic Surgery Procedures; Prognosis; Risk Factors; Sentinel Lymph Node Biopsy; skin cancer; solid organ transplant; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tumors of the skin and soft tissue. Premalignant lesions; Graft(material); Skin disease; solid organ transplant; Melanoma; Solid organ; Transplantation; Malignant tumor; Homotransplantation; Skin cancer; Treatment; Surgery; Malignant melanoma; Graft; Skin; Cancer
• ISSN: 1600-6135; 1600-6143
• DOI: 10.1111/j.1600-6143.2010.03078.x

This manuscript outlines estimated risk and clinical course of pretransplant MM, donor‐transmitted MM and de novo MM posttransplantation and includes an analysis of risk factors for metastasis, data from clinical studies and current and proposed management. MM in situ and thin melanoma (<1 mm) in the transplant population has similar recurrence and survival estimates to those in the general population. A minimum wait time of 2 years prior to transplantation is suggested for MM with a Breslow depth <1 mm and no clinical evidence of metastasis. More advanced MM may adopt a more aggressive course in transplant recipients. Sentinel lymph node biopsy may be of additional prognostic benefit. Revision of immunosuppression in the management of de novo melanoma in collaboration with the transplant team should be considered. Larger studies utilizing uniform staging criteria or at minimum Breslow depth, are required to assess true risk and outcome of MM in the immunosuppressed transplant population. Emphasis remains on patient education and regular screening to provide early detection of MM. This collaborative review addresses the clinical course of transplant associated melanoma and outlines a proposed strategy for management.