Primary prevention of skin dysplasia in renal transplant recipients with photodynamic therapy: a randomized controlled trial

TY - JOUR

T1 - Primary prevention of skin dysplasia in renal transplant recipients with photodynamic therapy

T2 - a randomized controlled trial

AU - Togsverd-Bo, K

AU - Omland, S H

AU - Wulf, H C

AU - Sørensen, S S

AU - Haedersdal, M

N1 - © Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.

PY - 2015/11

Y1 - 2015/11

N2 - Organ transplant recipients (OTRs) are at high risk of developing cutaneous squamous cell carcinoma (SCC); prevention includes early treatment of premalignant actinic keratosis (AK). Photodynamic therapy (PDT) is a noninvasive field therapy that reduces new AKs in patients with existing AK and delays SCC development in mice. We investigated the effect of repeated PDT over 5 years for primary prophylaxis of skin dysplasia. These data represent an interim analysis of an on-going randomized controlled trial. During 2008-2011, 25 renal transplant recipients with clinically normal skin were randomized to split-side PDT of the face, forearm and hand, the contralateral side serving as untreated control. Patients received PDT on inclusion and at 6-monthly intervals for 5 years. Blinded evaluation was performed at each visit. We found that prophylactic PDT significantly delayed onset of AK compared with untreated skin, p-=-0.020. At 3-year follow-up, we observed AK in 63% of patients in untreated skin areas compared with 28% of patients in PDT-treated skin, with a total number of cumulated AKs in untreated skin (n-=-43) compared with PDT-treated skin (n-=-8), p-=-0.005. These preliminary data indicate a novel approach to early prevention of skin dysplasia that may reduce morbidity from multiple AKs and SCCs in OTR. The authors show in an interim analysis of a randomized controlled trial that prophylactic photodynamic therapy twice a year for five years prevents the onset of skin dysplasia compared to untreated control renal transplant recipients.

AB - Organ transplant recipients (OTRs) are at high risk of developing cutaneous squamous cell carcinoma (SCC); prevention includes early treatment of premalignant actinic keratosis (AK). Photodynamic therapy (PDT) is a noninvasive field therapy that reduces new AKs in patients with existing AK and delays SCC development in mice. We investigated the effect of repeated PDT over 5 years for primary prophylaxis of skin dysplasia. These data represent an interim analysis of an on-going randomized controlled trial. During 2008-2011, 25 renal transplant recipients with clinically normal skin were randomized to split-side PDT of the face, forearm and hand, the contralateral side serving as untreated control. Patients received PDT on inclusion and at 6-monthly intervals for 5 years. Blinded evaluation was performed at each visit. We found that prophylactic PDT significantly delayed onset of AK compared with untreated skin, p-=-0.020. At 3-year follow-up, we observed AK in 63% of patients in untreated skin areas compared with 28% of patients in PDT-treated skin, with a total number of cumulated AKs in untreated skin (n-=-43) compared with PDT-treated skin (n-=-8), p-=-0.005. These preliminary data indicate a novel approach to early prevention of skin dysplasia that may reduce morbidity from multiple AKs and SCCs in OTR. The authors show in an interim analysis of a randomized controlled trial that prophylactic photodynamic therapy twice a year for five years prevents the onset of skin dysplasia compared to untreated control renal transplant recipients.

U2 - 10.1111/ajt.13358

DO - 10.1111/ajt.13358

M3 - Journal article

C2 - 26018207

SN - 1600-6135

VL - 15

SP - 2986

EP - 2990

JO - American Journal of Transplantation

JF - American Journal of Transplantation

IS - 11

ER -