Introduction
Skin cancer is the most common malignancy in kidney transplant recipients (KTRs), with a higher aggressiveness due to prolonged immunosuppression. Optimizing immunosuppressive regimens may reduce risk while preserving graft function. This study aimed to determine the long-term incidence and characteristics of skin cancer in KTRs receiving steroid-free, reduced-dose calcineurin inhibitor therapy.
Methods
We conducted a retrospective cohort study including all KTRs transplanted between 2008 and 2018 at Colombiana de Trasplantes. Demographic, clinical, and histopathological data were extracted from institutional records. Patients were stratified by the occurrence of skin cancer. Statistical analyses included descriptive and comparative estimates, Kaplan–Meier survival curves, and log-rank tests.
Results
A total of 1660 KTRs were analyzed, with 34 developing skin cancer, yielding a cumulative incidence of 2.05%. Patients with skin cancer were significantly older at transplantation than those without (52.5 ± 10.7 vs. 43.2 ± 13.3 years, p < 0.001). No other baseline variables differed between groups. The cumulative risk of skin cancer increased progressively with follow-up: 7.1% at 5 years and 17.8% at 10 years post-transplant.
Conclusion
This single-center study is the first in Colombia to describe long-term skin cancer outcomes in kidney transplant recipients (KTRs) under steroid-free, reduced-dose immunosuppression. The incidence observed in this cohort was lower than that reported in international series, which may reflect a potential protective effect of optimized immunosuppressive regimens; however, the possibility of underdiagnosis cannot be excluded. These findings highlight the need for sustained dermatologic surveillance beyond 5 years post-transplant and support strategies to optimize immunosuppressive regimens.
Keywords
Skin neoplasms; Kidney transplantation; Incidence; Immunosuppression therapy; Kaplan-Meier estimate