INTRODUCTION TO TRANSPLANT DERMATOLOGY

Forty years ago, the world marveled at the news of the first heart transplant and was saddened by the transplant recipient's not unexpected death 18 days later. Today it is not uncommon to see a cardiac transplant recipient living well 15 or more years after transplantation. Unfortunately, it is also common to see that patient plagued with multiple skin cancers. When solid organ transplantation was in its infancy in the 1960s and 1970s, surviving the immediate transplant period was the most pressing concern. Today, patients leave the hospital quickly after transplantation, and the challenges involve managing the complications of years of illness and immunosuppression: diabetes, hypertension, coronary artery disease, peripheral vascular disease, and skin cancer.

SOLID ORGAN TRANSPLANTATION AND SKIN CANCER

Over many years, solid organ transplantation has evolved into a commonly practiced, successful life-saving medical intervention. An intersection of advances in physiology, immunology, pharmacology, surgical technique, and critical-care medicine has made solid organ transplantation the standard of care for many instances of kidney, heart, lung, and liver failure. Initial attempts at organ transplantation were disappointing in terms of both allograft and patient survival. Although there were widely publicized successes in living related kidney transplants in the 1950s, it was not until 1962 that a long-term successful cadaveric renal transplant was performed in the United States. Surviving a transplant for more than a brief time was accomplished with the use of potent immunosuppressive agents.