Malignant Melanoma in a Candidate for Heart Transplantation

Abstract

A superficial spreading melanoma (Breslow thickness 0.4 mm) was diagnosed in a 65-year-old candidate for heart transplantation due to refractory end stage heart failure. After extensive review of the literature (USA and Europe), no clear guidelines about the management of candidates for transplantation with a previous diagnosis of melanoma were found. As this patient had a 5-year probability of survival higher than 95% and heart transplantation was necessary for saving his life, the final decision was to perform the transplantation. Unfortunately, the patient died of heart failure before a suitable heart became available. This case stresses the need for early and continuous dermatological evaluation of all candidates for solid organ transplantation. Clear guidelines for screening of skin cancer before transplantation are needed.

Malignant Melanoma in Solid Transplant Recipients

“…7 Outcomes in immunosuppressed solid organ transplant recipients are not as well documented, with data contained in a few case reports and case series. [8][9][10][11][12][13][14][15][16][17][18] Furthermore, even less published evidence lists prognostic information to assist in the interpretation of outcomes among patients with MM and organ transplants. [19][20][21][22][23][24] Some of us previously reported a series of cases from 1 institution, 19 and although prognostic information was more complete than in prior reports, the number of patients studied was too small to make outcome conclusions based on statistically valid comparisons.…”