1. Skin cancer surveillance in failed renal transplant recipients- one centre’s experience Faisal R. Ali 1 *, Durga Kanigicherla 2, Hamira Ul-Haque 1, Sheila A. Russell 2, John T. Lear 1 1 Department of Dermatology and 2 Transplant Unit, Manchester Royal Infirmary, Central Manchester University Hospitals NHS Foundation Trust, Oxford Road, Manchester M13 9WL *Corresponding author: Faisal R Ali, Academic Clinical Fellow (Dermatology) Email: f.r.ali.01@cantab.net Results Recommendations Introduction  There are over 1 million organ transplant recipients worldwide  Patients are being transplanted at an older age and surviving longer  Long term use of immunosuppressive agents, taken by organ transplant recipients, predisposes to an increased risk of skin cancer  In our renal transplant centre, patients with functioning transplants receive annual skin surveillance as part of their transplant review  Little is known about the clinical care of patients following renal transplant failure, when they are discharged to non-specialist clinics  We audited whether NICE guidelines regarding skin surveillance and reduction of immunosuppressive agents were being adhered to following failure of a renal transplant Methods  December 2010  51 patients identified as previous renal transplant recipients who were now on dialysis  Complete data available for 39 patients  Data points collected included:  Number & dates of transplants  Nature & commencement date of dialysis  Current immunosuppressive medications  Date of last skin check  Does patient recall previous skin cancer?  Has advice regarding sun protective measures been given? Principal findings  Immunosuppressive medications are being appropriately reduced following transplant failure  62% patients taking long-term immunosuppressive agents not receiving skin surveillance following failure of renal transplant  28% patients do not recall being given advice regarding the need for sun protective measures even when it has been given Figure 1: Nature & location of current dialysis Figure 2: Current immunosuppressive medications  Continue pharmacovigilance regarding dose reduction of immunosuppressive agents following transplant failure  Ongoing education of all organ transplant recipients about increased risk of skin cancer, need for regular self-surveillance and full skin examination  All current patients with failed renal transplants to be informed of above  In future, patients to be given such information in writing upon discharge from transplant clinic Figure 3: Has skin been checked following failure of renal transplant? Figure 4: Does patient recall having been given advice on need for sun protective measures? Note: documentary evidence of all patients attending for transplant review having been given such advice Figure 1: Nature & location of current dialysis Figure 2: Current immunosuppressive medications References  NICE Guidelines 2006. Improving outcomes for people with skin tumours including melanoma.  British Journal of Transplantation Supplement Winter 2010/2011