Skin Cancer in Recipients of Liver and Kidney Transplants: Calcineurin Versus mTOR Inhibitors
Posted: Monday, August 31, 2020
For people who have received kidney and liver transplants, switching from calcineurin inhibitors to mammalian target of rapamycin (mTOR) inhibitors may reduce the occurrence of non-melanoma skin cancer, according to findings presented in the journal Renal Failure. James P. O’Neill, MD, of Beaumont Hospital and the Royal College of Surgeons in Ireland, Dublin, and colleagues, observed a “marked” reduction in the occurrence of non-melanoma skin cancer in patients who switched to mTOR inhibitor–based immunosuppression—and without deterioration in renal function.
“Following conversion to sirolimus, there were 50% [fewer] individual non-melanoma skin cancers across all recipients in both transplant groups,” the authors concluded.
In this retrospective study, the authors focused on data from the Irish National Kidney and Liver Transplant Programs and the National Cancer Registry Ireland to determine the incidence rate of non-melanoma skin cancer among patients who received a liver or kidney transplant. From January 1994 to 2015, there were 4,536 kidney transplants and 574 liver transplants in Ireland. Of that total, 85 and 88 kidney and liver recipients, respectively, were transitioned to sirolimus-based immunosuppression.
For those who received a kidney transplant, the rate of non-melanoma skin cancer was 131 per 1,000 patients before the switch to sirolimus, and 68 per 1,000 patients after the transition. Of the patients who received a liver transplant, the rate of skin cancer was 64 per 1,000 patients before switching to sirolimus, and 30 per 1,000 patients after the switch.
The kidney transplant recipients were followed up for a median of 3.4 years. The liver transplant recipients were followed up for a median of 6.6 years.
Disclosure: The authors reported no conflicts of interest.