Advances in Management of Merkel Cell Carcinoma in Organ Transplant Recipients: Role of Polyoma Virus and Immunosuppression

Background: Keratinocyte carcinomas, particularly squamous cell carcinoma (SCC), occur more frequently and aggressively in solid-organ transplant recipients (SOTRs) than in the general population. Systemic retinoids are effective in secondary prevention of keratinocyte carcinomas in this population, but their use is limited by adverse effects including a rebound effect in cases of treatment discontinuation. Objective: Our aim was to determine whether low-dose acitretin is efficient in the secondary prevention of keratinocyte carcinomas in SOTRs. Methods: This retrospective case-crossover study was conducted at a specialized dermatology clinic for SOTRs in a large transplantation center in 2010–2017. Patients with at least 1 previous keratinocyte carcinoma who were treated with acitretin 10 mg/day for 2 years were included. The main outcome was the difference in the number of new keratinocyte carcinomas diagnosed during treatment compared to during the 2-year pretreatment period. Results: The cohort included 34 SOTRs. A significant reduction in the mean number of new keratinocyte carcinomas during treatment relative to the pretreatment period was observed (1.7 vs. 3.6, –53% p = 0.002). Similar results were noted on analysis by tumor type, for both SCC and basal cell carcinoma. Conclusion: This study of SOTRs demonstrated positive results for low-dose acitretin as a chemoprevention of keratinocyte carcinomas in this population.

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The role of sport-based social networks in the management of long-term health conditions: Insights from the World Transplant Games

International Review for the Sociology of Sport ◽

10.1177/1012690220979202 ◽

2020 ◽

pp. 101269022097920

Author(s):

Gareth Wiltshire ◽

Nicola J Clarke ◽

Cassandra Phoenix ◽

Carl Bescoby

Keyword(s):

Social Networks ◽

Social Engagement ◽

Sport Participation ◽

Organ Transplant ◽

Unintended Consequences ◽

Health Conditions ◽

Transplant Recipients ◽

Organ Transplant Recipients

In the context of an increasing clinical need to better support self-managemt for people living with long-term health conditions an interest in the role of social networks has emerged. Given that sport participation often provides opportunities for social engagement, a space to explore Self-managemt at the intersection of medical sociology and the sociology of sport has opened up. This article presents findings from an exploratory qualitative study with organ transplant recipients who have participated in Transplant Games events – national and international multi-sport competitions for organ transplant recipients. Our findings illustrate how sport-based Social networks serve as resources for health-related knowledge, provide participants with additional affective support and help shape health expectations for the future. Although sport-based Social networks were seen as an overwhelmingly positive resource for our participants, it is plausible that harmful unintended consequences could arise for patients with existing Self-managemt issues. As such, it is recommended that people seeking to use sport as a tool to enhance illness Self-managemt should consider the various and powerful ways that Social networks can be impactful and anticipate the potential consequences accordingly.

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