Ascha M, et al. - This study encompassed an investigation of the risk factors and characteristics of renal transplant recipients who developed melanoma. A greater risk of developing melanoma was disclosed in the renal transplant recipients than the general population. The identified risk factors could assist the clinicians in providing adequate care for patients in this vulnerable group.

Methods

• The plot of this trial was a cohort study of a large national data registry.
• It examined the renal transplant recipients, selected from the United States Renal Data System (USRDS) database from the years 2004 through 2012.
• A scrutiny was pursued of the variations in the baseline characteristics between those who did and did not develop melanoma.
• This was followed by a survival analysis.
• The inclusion criteria consisted of patients with renal transplants who received a diagnosis of melanoma according to any inpatient or outpatient claim associated with a billing code for melanoma.
• The exclusion criteria comprised of a history of pretransplant melanoma, previous kidney transplantation, or transplantation after 2012 or before 2004.
• Data analysis was performed from 2015 to 2016.
• The exposure consisted of the receipt of a renal transplant.
• The incidence and risk factors for melanoma were included as the main outcome measure.

Results

• Among the 105,174 patients (64,151 [60.7%] male; mean [SD] age, 49.6 [15.3] years) who received kidney transplants between 2004 and 2012, 488 (0.4%) presented with a record of melanoma after transplantation.
• The prominent risk factors for developing melanoma vs not developing melanoma were older age among recipients (mean [SD] age, 60.5 [10.2] vs 49.7 [15.3] years; P < .001) and donors (42.6 [15.0] vs 39.2 [15.1] years; P < .001), male sex (71.5% vs 60.7%; P < .001), recipient (96.1% vs 66.5%; P < .001) and donor (92.4% vs 82.9%; P < .001) white race, less than 4 HLA mismatches (44.9% vs 37.1%; P=.001), living donors (44.7% vs 33.7%; P < .001), and sirolimus (22.3% vs 13.2%; P < .001) and cyclosporine (4.9% vs 3.2%; P=.04) therapy.
• Older recipient age (hazard ratio [HR] per year, 1.06; 95% CI, 1.05-1.06; P < .001), recipient male sex (HR, 1.53; 95% CI, 1.25-1.88; P < .001), recipient white race, living donors (HR, 1.35; 95% CI, 1.11-1.64; P=.002), and sirolimus (HR, 1.54; 95% CI, 1.22-1.94; P < .001) and cyclosporine (HR, 1.93; 95% CI, 1.24-2.99; P=.004) therapy, served as the risk factors significant on survival analysis.
• It was noted that the age-standardized relative rate of melanoma in USRDS patients was 4.9 compared with Surveillance, Epidemiology, and End Results patients across all years .
• The data disclosed that a Kaplan-Meier estimate of the median time to melanoma among those patients who did develop melanoma was 1.45 years (95% CI, 1.31-1.70 years).