Abstract

Skin cancer is common after solid organ transplantation, but few have investigated it after lung transplant (LTx). We assessed incidence and predictors of non-melanoma skin cancer (NMSC) post-LTx. We studied patients who underwent LTx at our center from 2012 to 2015. Of 287 patients, mean age was 59.6±11years, 170 (59.2%) were men, and 231 (80.5%) were white. Seventy-six (26.5%) developed NMSC over a median follow-up of 32months (IQR, 23-45). Of those with NMSC, 37% developed subsequent skin cancer of the same type. Independent predictors of decreased odds of NMSC and squamous cell carcinoma (SCC) were non-white race (P=.002; P=.003) and body mass index >30kg/m2 compared with underweight patients (P=.001, P=.009). Patients with skin cancer pre-LTx had higher risk of post-LTx skin cancer (P=.02). Voriconazole use ≥100days was associated with increased risk of SCC (P=.03), but not increased risk of basal cell carcinoma. Out of 76, 4 (5.3%) died from skin cancer. Retrospective, single-center study. Squamous cell carcinoma risk post-LTx may increase with prolonged voriconazole use in white patients with pre-LTx history of skin cancer, whereas excess body weight may be protective from NMSC. Regular pre- and post-LTx skin cancer screenings and guidelines are warranted.

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