Meds and working outside

[skuch65]

My gfr is down to 17% (was at 19% in Feb) and I have a couple of live donors lined up for transplant.  Center will not do anything til i'm at 15% two months in a row.  I work outside in the weather and I was wondering if any of the meds after transplant recommends staying out of the sunlight?  I went to the transplant class and didn't even think about asking that question when we were going over meds. Thanks for any info.

[okarol]

82% of kidney transplant patients develop skin cancer after 20 years; comprehensive education urged.
Transplant News • Feb, 2008 •

The incidence of skin cancer in solid organ transplant recipients is up to 200-fold that of age matched controls due mainly to the necessity of taking immunosuppressive drugs and transplant recipients need far more comprehensive education if the problem is going to be controlled , according to a new study.

Summer Youker, MD, FAAD, the lead researcher on the study, said studies show that as many as 82% of kidney transplant recipients develop skin cancer 20 years after being transplanted, and a study of Australian heart transplant recipients found that 27% of deaths occurring four years after transplantation were due to skin cancer. Youker, an assistant professor of dermatology at Saint Louis University School of Medicine in St. Louis, MO, presented the study results at the 66th Annual Meeting of the American Academy of Dermatology.

"Educating transplant patients about the risk of skin cancer is essential, but multiple studies have shown that education during their hospital stay is not retained by patients and is not enough to change patient behavior regarding sun protection," Youker said. "Our findings confirmed that the majority of transplant recipients surveyed did not know they were at risk of developing skin cancer, and many of the reasons they gave for not practicing proper sun protection or seeing a dermatologist could be remedied by developing an intensive educational approach that raises awareness of the prevalence of this real health threat."

In Youker's study, a total of 298 solid organ transplant patients (65% males, 35% females) who attended the outpatient transplant clinics at Saint Louis University completed a two-page survey to evaluate their comprehension of skin cancer risk, their compliance with skin cancer preventive measures, and their attitudes about sunscreen use and skin screenings. The survey revealed 62% of respondents did not know they were at risk for skin cancer, and 73% of respondents stated that they were not informed about the risk of skin cancer following their organ transplant. In fact, only 21% of patients had seen a dermatologist since their transplant, and even less - 14% -- were receiving annual skin exams.

A breakdown of the reasons for not seeing a dermatologist showed that 64% said they "did not know about the increased risk" and 7% said that they "do not want to attend another doctor's appointment." Only 28% of respondents reported wearing sunscreen regularly, a slight increase from 22% who reported wearing sunscreen regularly before being transplanted.

Youker said reasons for not wearing sunscreen varied widely among survey participants: 33% responded "I forget to put it on," 25% said "I don't think it is important to use sunscreen," 16% said they are "not in the sun very much," 11% said "I like looking tan," 8% said they "don't like the way it feels," and 5% said it takes too much time to put on."

"Because the time around an organ transplantation is consumed with more pressing issues of rejection and infections, patients cannot be expected to recall information regarding the risks of sun exposure," Youker explained. "Clearly, another method of informing patients of this risk is needed - preferably one involving dermatologists, who can assist the transplant team with strategies to educate and treat this high-risk patient population."

Youker backed up the recommendation by citing a recent study that found the patients who received an intensive educational program in which written reminders reinforced the risk of skin cancer fared significantly better in terms of complying with the recommended protection tips than those patients who didn't receive the education.

"Regular correspondence with transplant patients concerning the risk of skin cancer and referral to a dermatologist for initial skin screening, assessment of risk factors and detailed education about skin cancer prevention could help reduce the incidence in these patients," Youker concluded.

For more information about skin cancer go to: www.skincarephysicians.com and click on "SkinCancerNet."

[Chris]

Does not seem to matter which transplant med you are on, but staying in sunlight can be harmful along with causing dizzyness.
I am told to wear 50 or higher SPF sunblock and I'm also prescribed an oiment to help prevent skin cancer that is applied every night.
There is also a catalog of stuff you can purchase to help protect you if your outside that my transplant dermatologist gave me. However the products are common sense but labels as "specially protects against"

[monrein]

Being in the sun is definitely an issue post trx.  I wear 60 sunscreen every single day, winter and summer, it goes on as part of my regular dressing ritual.  I also see a dermatologist once a year or every two years and we examine my body for funny-looking things that grow and we remove them.  This helps to reassure me since my mother died of skin cancer (melanoma) at age 46 and like all my family I'm very fair-skinned and blonde.   I also wear a hat, long sleeves and gloves if I'm gardening or canoeing.

[jbeany]

Basically, after the transplant, you have to take the precautions against sun exposure that the doctors tell everyone, healthy or transplanted, that they should do!