Knowledge of risks, benefits improves care of solid organ transplant recipients

In diverse patients who are solid organ transplant recipients (SOTRs), knowing the risks for cutaneous squamous cell carcinoma (cSCC) and benefits can lead to improvements in their care, suggests a study.

This cohort and nested case-control study evaluated the risk of cSCC in relation to medications used by SOTRs. A total of 3,308 SOTRs and 65,883 persons without transplantation between 2009 and 2019 were included in the analysis.

The researchers identified incident cSCC from pathology data and medications from pharmacy data. They estimated adjusted hazard ratios (HR) and 95 percent confidence intervals (CIs) using Cox proportional hazards analysis, with voriconazole examined as a time-dependent variable.

The annual incidence of cSCC was 1.69 percent and 0.30 percent in SOTRs and in persons without transplantation, respectively. For cSCC associated with lung transplant, the adjusted HR was 14.83 (95 percent CI, 9.85‒22.33) for lung and 6.53‒10.69 for other organs. Such risk was higher among Latins than other non-White groups.

Among lung recipients, the HR was 1.14 (95 percent CI, 1.04‒1.26) for each month of voriconazole use. Azathioprine use for ≥7 months, in relation to mycophenolate mofetil intolerance, resulted in a 4.22-fold (95 percent CI, 1.90‒9.40) elevated risk of cSCC. Notably, belatacept and other immunosuppressive medications showed no association with such risk.

The study was limited by the relatively small number of events, according to the researchers.