1179P - The underestimated skin cancer risk after liver transplantation: A meta-analysis of 147154 patients

Background

Recent reports have been shown an increased risk of de-novo malignancies in liver transplant recipients (LTRs) which is reported to be a leading cause of mortality in these patients. The aim of this systematic review and meta-analysis was to assess the prevalence of skin cancer in LTRs.

Methods

We systematically searched in five databases till 20^th April 2023 through the search term ("liver transplantation" OR "liver transplant") AND ("skin cancer" OR "melanoma" OR "squamous cell carcinoma" OR "non-melanoma skin cancer" OR "post-transplant cancer" OR "post transplant cancer"). We used random effect model to overcome the significant heterogeneity we observed.

Results

A total of 34 studies, with 147154 LTRs were included. The pooled prevalence of skin cancer (all types) was 4.8% (95%confidence interval (CI): 3.6-6.5). Subgroup analysis based upon the follow up duration of each study, indicated that skin cancer prevalence increased with long duration of follow up: 0-4 years, 2.4% (95%CI: 0.5-9.9), 4-8 years, 4.2% (95%CI 2.9-6.2), and >8 years, 7.6% (95%CI: 4.7-12). Australia followed by South America had the highest prevalence of skin cancer, 20.6% (95%CI: 12.9-31.3), and 9.4% (95%CI: 5.8-14.8), in order; while Asia had the lowest prevalence 0.4% (95%CI: 0-3.8). The most common type of skin cancers was non-melanoma skin cancer reported as a combined type with a prevalence of 2.9% (95%CI: 1.1-6.9), followed by squamous cell carcinoma, basal cell carcinoma and Bowen’s cancer, 2.5% (95%CI: 1.4-4.4), 2.5% (95%CI: 1.5-4.1) and 0.8% (95%CI: 0.2-3.2), in order.

Conclusions

Consistent with what it has been reported for other organ transplants, the results from this study showed that skin cancer following liver transplantation is not rare. LTRs in Australia should receive annual dermatologic examination due to their high prevalence of skin cancers. Moreover, non-melanoma skin cancers may be the prevalent type if skin cancer is suspected in LTRs. Substantial dermatological surveillance programs are recommended in LTRs to improve quality of life as well as the associated mortality; especially with the increased prevalence after long follow up durations.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.