Skin Cancer after Organ Transplantation

Hardcover | May 8, 2009

EditorEggert Stockfleth, Claas Ulrich

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Organ transplantation has been performed for almost 40 years with steadily increasing success regarding long-time survival of the graft, as well as quality of life for the patient. However, graft tolerance only can be achieved via induction and maintenance of an impaired immunological surveillance. An increase of skin cancers as a consequence of the lowered cellular immunoresponse seems to parallel the overall increased long-time survival rate of organ transplant recipients. Against the background of chronic immunosuppression known risk factors like the amount of sun exposure prior and post transplantation, oncogenic viruses as well as the genetic background, and place of residence (latitude) are strongly related with the increased skin cancer incidence.The increasing incidence of non-melanoma skin cancer, paralleling a prolonged survival of patients after organ transplantation, represents a significant reason for morbidity and long-term morbidity in organ transplant recipients worldwide. The incidence of non-melanoma skin cancer in liver-, kidney- and heart transplant recipients varies from 1.5 to 22 %, 2 to 24 % and 6 to 34 % after <_20_520_years20_post20_transplant.20_ultraviolet20_radiation20_as20_well20_as20_immunosuppressive20_therapy20_are20_crucial20_risk-factors20_regarding20_the20_induction20_and20_progression20_of20_skin20_cancer.20_ultraviolet20_radiation20_is20_related20_to20_the20_induction20_of20_dna20_damage2c_20_as20_well20_as20_interference20_with20_langerhans20_cell20_antigen20_presentation20_and20_a20_th120_-20_th220_shift20_induced20_via20_a20_release20_of20_il-10.20_whereas20_the20_overall20_duration20_of20_immunosuppression20_and20_the20_cumulative20_dosage20_applied20_are20_relevant20_parameters20_in20_the20_evaluation20_of20_an20_increased20_tumor20_risk2c_20_individual20_differences20_between20_specific20_immunosuppressive20_agents20_remain20_unclear.20_the20_workup20_of20_genetic20_as20_well20_as20_other20_unclear20_phenomenon20_like20_the20_reverse20_bcc2f_scc20_ratio20_might20_shed20_some20_further20_light20_into20_the20_genesis20_and20_immunology20_of20_the20_non-melanoma20_skin20_cancer20_in20_general.0a_ 5="" years="" post="" transplant.="" ultraviolet="" radiation="" as="" well="" immunosuppressive="" therapy="" are="" crucial="" risk-factors="" regarding="" the="" induction="" and="" progression="" of="" skin="" cancer.="" is="" related="" to="" dna="" _damage2c_="" interference="" with="" langerhans="" cell="" antigen="" presentation="" a="" th1="" -="" th2="" shift="" induced="" via="" release="" il-10.="" whereas="" overall="" duration="" immunosuppression="" cumulative="" dosage="" applied="" relevant="" parameters="" in="" evaluation="" an="" increased="" tumor="" _risk2c_="" individual="" differences="" between="" specific="" agents="" remain="" unclear.="" workup="" genetic="" other="" unclear="" phenomenon="" like="" reverse="" _bcc2f_scc="" ratio="" might="" shed="" some="" further="" light="" into="" genesis="" immunology="" non-melanoma="" cancer="" general.="">

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From the Publisher

Organ transplantation has been performed for almost 40 years with steadily increasing success regarding long-time survival of the graft, as well as quality of life for the patient. However, graft tolerance only can be achieved via induction and maintenance of an impaired immunological surveillance. An increase of skin cancers as a cons...

From the Jacket

Skin Cancer after Organ Transplantation presents the state-of-the-art knowledge of cutaneous malignancies following organ transplantation. The life promoting and life enhancing benefits of solid organ transplantation is a major medical advance, but at the cost of the life-long immunosuppression needed to prevent rejection of the donate...

Format:HardcoverDimensions:520 pages, 9.25 × 6.1 × 0.27 inPublished:May 8, 2009Publisher:Springer USLanguage:English

The following ISBNs are associated with this title:

ISBN - 10:0387785736

ISBN - 13:9780387785738

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Table of Contents

Historical Perspective (Past Present Future).- Immunology of organ transplantation and allograft rejection.- Posttransplant Malignancies.- Kidney Transplantation.- Heart/lung Transplantation .- Liver Transplantation.- Bone Marrow Transplantation.- Other Transplants.- Immunosuppression.- Introduction and general issues.- Calcineurin inhibitors.- MMF/MMS.- m-TOR Inhibitors.- Azathioprine.- Corticosteroids.- FTY and other new drugs.- Induction therapies.- Tolerance induction.- Skin Immune System.- Posttransplant Malignancies General Overview.- Influence of organ and pre-existing disease.- Epidemiology and Region specific features.- Europe.- USA/Canada.- Australia/Asia.- Etiological factors in cutaneous carcinogenesis.- Introduction.- Photocarcinogenesis - DNA damage.- UV-induced immunosuppression.- Mechanisms related to immunosuppressive therapies.- Oncogenic viruses.- HPV Epidemiology.- UV-HPV Interactions.- HHV 8.- Molecular pathogenesis of BCC and SCC.- Genetic basis of melanoma.- Specific Skin Cancers.- Non-melanoma Skin Cancer.- Actinic keratosis.- Squamous cell carcinoma.- Basal cell carcinoma.- Malignancies in genitoanal area.- Malignant Melanoma.- Rare Skin Cancers.- Kaposi's sarcoma.- Merkel cell carcinoma.- Cutaneous lymphomas.- Prophylaxis and Therapy.- Prophylaxis and screening pre-transplantation.- Aftercare - the multi disc-approach.- Patient education.- Sunscreens and sun protection.- Dosage and choice/combination of immunosuppression.- Surgical interventions.- Specific management of field cancerisation.- Destructive management.- Systemic Chemoprevention.- Management of metastatic skin cancers in OTR.- Index.