Skin cancer in Australian heart transplant recipients

J Am Acad Dermatol. 1999 Jan;40(1):27-34. doi: 10.1016/s0190-9622(99)70525-6.


Background: Cutaneous malignancy is a major cause of morbidity in organ transplant recipients.

Objective: Our purpose was to report on skin cancer in Australian heart transplant recipients with analysis of HLA factors.

Methods: We reviewed histologically proven skin cancers in the first 455 patients undergoing organ transplantation in Sydney, Australia.

Results: The cumulative incidence of skin cancer was 31% at 5 years and 43% at 10 years with a squamous cell carcinoma/basal cell carcinoma ratio of 3:1. Caucasian origin, increasing age at transplantation, and duration of follow-up were significantly associated with skin cancer. Skin cancer accounted for 27% of 41 deaths occurring after the fourth year. Recipient HLA-DR homozygosity was associated with skin cancer overall, whereas HLA-DR7 was a protective factor in skin cancer overall, squamous cell carcinoma, and Bowen's disease. HLA-A1 and HLA-A11 were significant protective factors in Bowen's disease.

Conclusion: Skin cancer is a major cause of morbidity and long-term mortality in heart transplant patients.

MeSH terms

  • Australia / epidemiology
  • Carcinoma, Basal Cell / epidemiology
  • Carcinoma, Squamous Cell / epidemiology
  • Female
  • Follow-Up Studies
  • HLA Antigens / analysis
  • HLA Antigens / genetics*
  • HLA-DR Antigens / genetics
  • Heart Transplantation* / statistics & numerical data
  • Homozygote
  • Humans
  • Immunosuppression
  • Incidence
  • Logistic Models
  • Male
  • Middle Aged
  • Morbidity
  • Postoperative Complications / epidemiology*
  • Retrospective Studies
  • Risk Factors
  • Skin Neoplasms / epidemiology*
  • Time Factors


  • HLA Antigens
  • HLA-DR Antigens