Renal transplant recipients have an increased risk of developing non-melanoma skin cancer. Ultraviolet radiation is one of the major cofactors in the development of skin cancer in the immunosuppressed. In view of this, we undertook this study to determine the advice given to renal transplant recipients and their compliance with that advice. Two hundred and two renal transplant recipients were interviewed using a questionnaire. Their knowledge about the risk of non-melanoma skin cancer and preventive measures was not good, despite advice and literature given to newly transplanted patients at the time of discharge from hospital. Only 54% remembered receiving advice. Renal physicians and nurses gave advice to the majority, with dermatologists providing advice only in 17% of cases. The use of sun-protective measures such as sun avoidance and protective clothing was poor and the use of sun barrier creams was inappropriate. Only 30% of patients knew why extra precautions against sunlight were necessary. Health professionals and dermatologists in particular need to take a more active role in raising the awareness of renal transplant recipients to their increased risk of non-melanoma skin cancer.
The third edition of the British Transplantation Society Guidelines for the Prevention and Management of CMV Disease after Solid Organ Transplantation was published in March 2011. This article summarizes the important changes and advances in management in this rapidly evolving field. The pros and cons of universal, or targeted anti-cytomegalovirus (CMV) prophylaxis, and pre-emptive anti-CMV therapy are discussed, especially with respect to advances in CMV polymerase chain reaction monitoring. The evidence for oral anti-CMV prophylaxis using valganciclovir is presented, together with a summary of the treatment of CMV disease and emerging fields such as CMV vaccination, CMV genotyping, and drug resistance.
The colinearity of HA assay sensitivity with the receipt of PEx and EART limits some conclusions regarding the likely direction of causation. However, the association of differences in clinical practice with recognized perioperative complications of ABOiKTx identifies targets for further investigation and quality improvement.
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