A pan-European group of transplant dermatologists reviewed studies from 2000 to early 2026 on skin cancer after retransplantation (BJD, 19 October 2026). Kidney and heart registry data identify retransplantation as a marker of higher post-transplant skin cancer risk, and the one cohort reporting skin outcomes after a second kidney transplant found more aggressive squamous cell carcinoma in recipients who already had one.
Existing tools, including the SUNTRAC risk calculator, do not account for retransplantation or cumulative immunosuppression. The authors propose a five-tier framework based on prior skin cancer history: none, a single non-aggressive cSCC, multiple cSCCs, a histologically aggressive cSCC, or metastatic cSCC.
The evidence is thin, which the authors acknowledge, and they do not set surveillance intervals. The practical step is simpler: when a patient is listed for a second transplant, the transplant team should know their skin cancer history and arrange dermatology review.
- Ask about previous skin cancers when a transplant recipient is listed for a second graft.
- Arrange dermatology review before retransplantation for anyone with prior cSCC.
- Treat a history of aggressive or multiple cSCC as a reason for closer follow-up after the new graft.
- Share skin cancer history with the transplant team so immunosuppression choices can take it into account.
Why it matters
Retransplanted patients often need heavier immunosuppression, yet no guideline or risk tool currently singles them out.
Don't overread it
This is a narrative review with a conceptual framework; the tiers have not been tested against outcomes.
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