Kearney L, Hogan D, Conlon P, Roche M, O'Neill J P, O'Sullivan J B
Department of Plastic and Reconstructive Surgery, Beaumont Hospital, Beaumont, Dublin 9, Ireland.
Department of Head and Neck Surgery, Beaumont Hospital, Beaumont, Dublin 9, Ireland.
J Plast Reconstr Aesthet Surg. 2017 Jul;70(7):922-930. doi: 10.1016/j.bjps.2017.03.005. Epub 2017 Apr 7.
Renal transplantation is the most frequently performed transplant procedure. Immunosuppressive therapies have dramatically increased survival rates in transplant recipients but are associated with an increased risk of skin cancers. Recent changes in immunosuppressive strategies have been adopted with the aim of reducing this challenging adverse effect. Despite these new strategies, cutaneous malignancies tend to be numerous, aggressive and associated with a higher risk of local and distant dissemination than in the non-transplant population. This represents a significant workload for transplant physicians, dermatologists, and head and neck and plastic surgeons. This review highlights key concepts in the pathogenesis of skin cancer in transplant patients, the impact current and evolving immunosuppressive strategies and regimens will have on the epidemiology, and the management of cutaneous malignancies in renal transplant patients, with particular focus on the implications for the plastic surgery community.
肾移植是最常施行的移植手术。免疫抑制疗法显著提高了移植受者的生存率，但与皮肤癌风险增加相关。近期已采用免疫抑制策略的改变，旨在减少这一具有挑战性的不良反应。尽管有这些新策略，但与非移植人群相比，皮肤恶性肿瘤往往数量众多、侵袭性强且局部和远处播散风险更高。这给移植医生、皮肤科医生以及头颈和整形外科医生带来了巨大的工作量。本综述重点介绍了移植患者皮肤癌发病机制的关键概念、当前和不断演变的免疫抑制策略及方案对流行病学的影响，以及肾移植患者皮肤恶性肿瘤的管理，特别关注对整形外科领域的影响。
