Where there’s smoke, there’s fire — a brief report on skin malignancy incidence in renal, heart, and liver transplant recipients in Poland

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Introduction. The number of solid organ transplants is rising, increasing the population of long-term survivors. Immunosuppressive drugs, particularly calcineurin inhibitors, are linked to higher skin malignancy incidence, but large-scale studies on melanoma and non-melanoma skin cancer (NMSC) in Polish transplant recipients are lacking. Materials and methods. This study combines findings from a systematic review and meta-analysis on the risks of NMSC and melanoma in renal transplant patients using calcineurin inhibitors. It also presents a large dataset from Poland’s National Health Fund on skin malignancies incidence in kidney, heart, and liver transplant recipients (2010–2022). Results. The authors of this article analyzed data from over 17,000 Polish transplant recipients and compared skin malignancy incidence versus the general population. Renal transplant patients had higher NMSC risk: 1-year (0.09% vs. 0.04%, p < 0.001), 5-year (1.21% vs. 0.18%, p < 0.001), and 10-year (4.18% vs. 0.36%, p < 0.001). Liver transplant recipients showed increased NMSC risk at 1-year (0.09% vs. 0.04%, p < 0.001), 5-year (0.83% vs. 0.18%, p < 0.001), and 10-year (2.65% vs. 0.36%, p < 0.001). Heart recipients had higher NMSC risk at 5 years (0.8871% vs. 0.1774%, p < 0.001) and 10 years (4.0609% vs. 0.3597%, p < 0.001). Melanoma risk in renal recipients was increased: 1-year (0.02% vs. 0.01%, p < 0.001), 5-year (0.17% vs. 0.05%, p < 0.001), 10-year (0.36% vs. 0.1%, p < 0.001). Liver recipients had higher melanoma risk at 1 year (0.03% vs. 0.01%, p < 0.001), 5 years (0.2% vs. 0.05%, p < 0.001) and 10 years (0.2% vs. 0.1%, p < 0.001). Conclusions. The authors of this article nationwide dataset showed a significant association between heart, kidney, and liver transplantation followed by immunosuppression and an increased incidence of melanoma and NMSC. The melanoma risk in renal, liver, and heart transplant recipients in Poland was, on average, twice as high compared to the general population at 1 year, four and half times higher after 5 years, and almost nine times higher after 10 years. Similarly, the NMSC risk in this population was two and a half times higher after 1 year, seven and a half times higher after 5 years, and remained twenty two times higher after 10 years.

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