Review article: Risk of transmitting skin cancer by skin transplantation (2015)

At the time of this article, the European Union Tissues and Cells Directives guidelines contraindicated tissue donation in the presence of, or with a history of, donor cancer, with the exception of basal cell carcinoma. This article argues that non-lesional skin (and other tissues) from donors with premalignant (e.g. actinic keratosis, Bowen disease) or malignant (squamous cell carcinoma) skin lesions can be used for transplant. In contrast, malignant melanoma remains an absolute contraindication. Use of viable versus non-viable skin transplantation is discussed in terms of influence on potential transmission of tumor cells or tumor-associated viruses (e.g. papillomavirus). Occasional points made in the article have direct bearing on donor evaluation. For example a) a history of dysplastic nevus raises the relative risk of melanoma 15-fold, and b) tumors involving the skin may not only represent primary tumors, but could reflect metastatic disease. The review does not deal with other tumors that could involve skin, such as Kaposi sarcoma or Merkel cell tumor. The authors strongly emphasize a thorough physical skin examination in each tissue donor. Malignant melanoma incidence rates have more than quadrupled over the last 30 years in the UK.