Dermatology Scheduling Triage of Transplant Patients and Transplant Candidates to Improve Early Diagnosis and Prevention of Skin Cancer - Expert Consensus Recommendations

Sep 23, 2026

Uploaded by Elsa

Solid organ transplant recipients (SOTRs) face a markedly higher risk of aggressive skin cancers due to chronic immunosuppression, yet dermatology clinics lack standardized triage guidance for scheduling new patients before or after transplant. Multidisciplinary, longitudinal care and tailored counseling are required, but dedicated high-risk clinics remain limited. An expert consensus triage algorithm is proposed to support pre- and post-transplant referrals for concerning growths or routine skin cancer screening, emphasizing timely visits and risk-factor–based scheduling to enable prevention and early diagnosis.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages6

Reading Time15 min

AccessFree to download

Introduction

Background and Risk

Role of SUNTRAC and Existing Guidelines

Need for Scheduling Timeline

Triage Algorithm Overview

Target Patients and Referral Scenarios

Recommended Timing and Risk-Based Triage

Keywords

SUNTRAC

*Correspondence Kelsey E. Hirotsu, [Kelsey.hirotsu@gmail.com](Kelsey.hirotsu@gmail.com) Received: 01 April 2025 Accepted: 18 August 2025 Published: 11 September 2025 Citation: Hirotsu KE, Crowe L, Michalski-McNeely B, Arron ST, Bibee K, Bottomley MJ, Carr DR, Carter JB, Christensen SR, Chung C, Jambusaria A, Ken KM, Loss MJ, Paragh G, Plasmeijer EI, Proby C, Pugliano-Mauro M, Shahwan KT, Whitley MJ and Carroll BT (2025) Dermatology Scheduling Triage of Transplant Patients and Transplant Candidates to Improve Early Diagnosis and Prevention of Skin Cancer: International Immunosuppression and Transplant Skin Cancer Collaborative Expert Consensus Recommendations. Transpl. Int. 38:14711. doi: 10.3389/ti.2025.14711 Dermatology Scheduling Triage of Transplant Patients and Transplant Candidates to Improve Early Diagnosis and Prevention of Skin Cancer: International Immunosuppression and Transplant Skin Cancer Collaborative Expert Consensus Recommendations Kelsey E. Hirotsu 1 *, Lauren Crowe 2, Basia Michalski-McNeely 3, Sarah T. Arron 4, Kristin Bibee 5, Matthew J. Bottomley 6, 7, David R. Carr8, JoiB. Carter9, Sean R. Christensen 10, Christina Chung 11, Anokhi Jambusaria 12, Kimberly M. Ken 13, Manisha J. Loss 14, Gyorgy Paragh 15, ElsemiekeI. Plasmeijer 16,17, Charlotte Proby 18, Melissa Pugliano-Mauro 19, Kathryn T. Shahwan 8, Melodi Javid Whitley20 and Bryan T. Carroll 21 1Department of Dermatology, Stanford University School of Medicine, Redwood City, CA, United States, 2Dermatology Associates of Tallahassee, Tallahassee, FL, United States, 3Division of Dermatology, Washington University in St. Louis, St. Louis, MO, United States, 4Palo Alto Foundation Medical Group, Palo Alto, CA, United States, 5Department of Dermatology, University of Virginia, Charlottesville, VA, United States, 6CAMS Oxford Institute, University of Oxford, Oxford, United Kingdom, 7Oxford Kidney and Transplant Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom, 8Division of Dermatology, The Ohio State University, Columbus, OH, United States, 9Department of Dermatology, Dartmouth Hitchcock Medical Center, Lebanon, NH, United States, 10Department of Dermatology, Yale School of Medicine, New Haven, CT, United States, 11Schweiger Dermatology Group, New York, NY, United States, 12Division ofDermatology, Department of Internal Medicine, Dell Medical School, University of Texas,Austin, TX, United States, 13Department ofDermatology,Penn State Health,PennState MiltonS. HersheyMedicalCenter, Hershey,PA, UnitedStates, 14DepartmentofDermatology, Johns Hopkins University School of Medicine, Baltimore, MD, United States, 15Department of Dermatology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States, 16Department of Dermatology, The Netherlands Cancer Institute, Amsterdam, Netherlands, 17Department ofDermatology, Leiden UniversityMedical Centre, Leiden, Netherlands, 18Molecularand ClinicalMedicine, School ofMedicine, University of Dundee, Dundee, United Kingdom, 19Department of Dermatology, University of Pittsburgh, Pittsburgh, PA, United States, 20Department of Dermatology, Duke University School of Medicine, Durham, NC, United States, 21Department of Dermatology, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, United States Solid organ transplant recipients (SOTRs) have a high risk of developing aggressive skin cancers. However, there are no standardized triage guidelines to assist dermatology clinics with scheduling new patients pre- or post-transplant. Dermatologic care of SOTRs requires multidisciplinary coordination, extensive assessment, tailored counseling, and longitudinal care. Specialized high-risk transplant clinics are designed to address this clinical need but are a limited resource. This triage algorithm aims to provide a practical framework for tertiary care centers or community practice clinics receiving pre-or posttr

FAQs

Why do transplant patients need skin cancer triage scheduling guidance?

Solid organ transplant recipients have a much higher risk of aggressive skin cancers from chronic immunosuppression, and transplant candidates also need timely screening. The document notes that standardized triage guidelines for scheduling are lacking.

What tool helps stratify post-transplant skin cancer risk?

The Skin and Ultraviolet Neoplasia Transplant Risk Assessment Calculator (SUNTRAC) stratifies SOTRs by skin cancer risk for post-transplant screening guidance.

How should patients with active concerning growths be scheduled after transplant?

The expert panel recommends SOTRs be seen within 1–2 weeks for evaluation of an active growth and triaged according to their risk factors for the initial post-transplant screening visit.

Sep 23, 2026

Uploaded by Elsa