An ethical dilemma: malignant melanoma in a 51-year-old patient awaiting simultaneous kidney and pancreas transplantation for type 1 diabetes
Summary Malignant melanoma is a high‐risk skin cancer that, in potential transplant recipients, is considered a substantial contraindication to solid organ transplantation due to significant risk of recurrence with immunosuppression. Current guidelines stipulate waiting between 3 and 10 years after...
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| Veröffentlicht in: | British journal of dermatology (1951) 2016-07, Vol.175 (1), p.172-174 |
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| container_title | British journal of dermatology (1951) |
| container_volume | 175 |
| creator | Kirby, L. C. Banerjee, A. Augustine, T. Douglas, J.F. |
| description | Summary
Malignant melanoma is a high‐risk skin cancer that, in potential transplant recipients, is considered a substantial contraindication to solid organ transplantation due to significant risk of recurrence with immunosuppression. Current guidelines stipulate waiting between 3 and 10 years after melanoma diagnosis. However, in young patients with end‐stage organ failure and malignant melanoma, complex ethical and moral issues arise. Assessment of the true risk associated with transplantation in these patients is difficult due to lack of prospective data, but an autonomous patient can make a decision that clinicians may perceive to be high risk. The national and worldwide shortage of available organs also has to be incorporated into the decision to maximize the net benefit and minimize the risk of graft failure and mortality. The incidence of malignant melanoma worldwide is increasing faster than that of any other cancer and continues to pose ethically challenging decisions for transplant specialists evaluating recipients for solid organ transplantation. |
| doi_str_mv | 10.1111/bjd.14554 |
| format | Article |
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Malignant melanoma is a high‐risk skin cancer that, in potential transplant recipients, is considered a substantial contraindication to solid organ transplantation due to significant risk of recurrence with immunosuppression. Current guidelines stipulate waiting between 3 and 10 years after melanoma diagnosis. However, in young patients with end‐stage organ failure and malignant melanoma, complex ethical and moral issues arise. Assessment of the true risk associated with transplantation in these patients is difficult due to lack of prospective data, but an autonomous patient can make a decision that clinicians may perceive to be high risk. The national and worldwide shortage of available organs also has to be incorporated into the decision to maximize the net benefit and minimize the risk of graft failure and mortality. The incidence of malignant melanoma worldwide is increasing faster than that of any other cancer and continues to pose ethically challenging decisions for transplant specialists evaluating recipients for solid organ transplantation.</description><identifier>ISSN: 0007-0963</identifier><identifier>EISSN: 1365-2133</identifier><identifier>DOI: 10.1111/bjd.14554</identifier><identifier>PMID: 27484276</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Decision making ; Diabetes mellitus (insulin dependent) ; Diabetes Mellitus, Type 1 - complications ; Diabetic Nephropathies - complications ; Ethics ; Graft rejection ; Grafts ; Humans ; Immunosuppression ; Kidney Failure, Chronic - complications ; Kidney Failure, Chronic - surgery ; Kidney transplantation ; Kidney Transplantation - ethics ; Kidney Transplantation - methods ; Male ; Medical ethics ; Melanoma ; Melanoma - complications ; Middle Aged ; Pancreas transplantation ; Pancreas Transplantation - ethics ; Pancreas Transplantation - methods ; Skin cancer ; Skin Neoplasms - complications ; Transplants & implants</subject><ispartof>British journal of dermatology (1951), 2016-07, Vol.175 (1), p.172-174</ispartof><rights>2016 British Association of Dermatologists</rights><rights>2016 British Association of Dermatologists.</rights><rights>Copyright © 2016 British Association of Dermatologists</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4944-3febca8368d214c0a930ec9a0115fabe1eb39c9ee03ffd562c94ea5331dfcee23</citedby><cites>FETCH-LOGICAL-c4944-3febca8368d214c0a930ec9a0115fabe1eb39c9ee03ffd562c94ea5331dfcee23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fbjd.14554$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fbjd.14554$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27484276$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kirby, L. C.</creatorcontrib><creatorcontrib>Banerjee, A.</creatorcontrib><creatorcontrib>Augustine, T.</creatorcontrib><creatorcontrib>Douglas, J.F.</creatorcontrib><title>An ethical dilemma: malignant melanoma in a 51-year-old patient awaiting simultaneous kidney and pancreas transplantation for type 1 diabetes</title><title>British journal of dermatology (1951)</title><addtitle>Br J Dermatol</addtitle><description>Summary
Malignant melanoma is a high‐risk skin cancer that, in potential transplant recipients, is considered a substantial contraindication to solid organ transplantation due to significant risk of recurrence with immunosuppression. Current guidelines stipulate waiting between 3 and 10 years after melanoma diagnosis. However, in young patients with end‐stage organ failure and malignant melanoma, complex ethical and moral issues arise. Assessment of the true risk associated with transplantation in these patients is difficult due to lack of prospective data, but an autonomous patient can make a decision that clinicians may perceive to be high risk. The national and worldwide shortage of available organs also has to be incorporated into the decision to maximize the net benefit and minimize the risk of graft failure and mortality. The incidence of malignant melanoma worldwide is increasing faster than that of any other cancer and continues to pose ethically challenging decisions for transplant specialists evaluating recipients for solid organ transplantation.</description><subject>Decision making</subject><subject>Diabetes mellitus (insulin dependent)</subject><subject>Diabetes Mellitus, Type 1 - complications</subject><subject>Diabetic Nephropathies - complications</subject><subject>Ethics</subject><subject>Graft rejection</subject><subject>Grafts</subject><subject>Humans</subject><subject>Immunosuppression</subject><subject>Kidney Failure, Chronic - complications</subject><subject>Kidney Failure, Chronic - surgery</subject><subject>Kidney transplantation</subject><subject>Kidney Transplantation - ethics</subject><subject>Kidney Transplantation - methods</subject><subject>Male</subject><subject>Medical ethics</subject><subject>Melanoma</subject><subject>Melanoma - complications</subject><subject>Middle Aged</subject><subject>Pancreas transplantation</subject><subject>Pancreas Transplantation - ethics</subject><subject>Pancreas Transplantation - methods</subject><subject>Skin cancer</subject><subject>Skin Neoplasms - complications</subject><subject>Transplants & implants</subject><issn>0007-0963</issn><issn>1365-2133</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkcFu1DAQQC0EokvhwA8gS1zgkNaO7WzCrbstBVTBBejRmjiT4m3iBNtRm4_gn_GStgckJHzx5c2zR4-Ql5wd8XSO611zxKVS8hFZcVGoLOdCPCYrxtg6Y1UhDsizEHaMccEUe0oO8rUsZb4uVuTXiaMYf1gDHW1sh30P72gPnb1y4CLtsQM39ECto0AVz2YEnw1dQ0eIFhMBN2CjdVc02H7qIjgcpkCvbeNwpuD2oDMeIdDowYUx-WIaHRxtB0_jPCLl6WWoMWJ4Tp600AV8cXcfkm_vz75uP2QXX84_bk8uMiMrKTPRYm2gFEXZ5FwaBpVgaCpgnKs2mTjWojIVIhNt26giN5VEUELwpjWIuTgkbxbv6IefE4aoexsMdt3yfc1LzsuKKcn_A2UVk6Wq9tbXf6G7YfIuLaJzkTrJvJAyUW8XyvghBI-tHr3twc-aM73PqVNO_SdnYl_dGae6x-aBvO-XgOMFuEnt5n-b9ObT6b0yWyZsiHj7MAH-WhdrsVb68vO53mwvt98LtdGn4jfFwbmh</recordid><startdate>201607</startdate><enddate>201607</enddate><creator>Kirby, L. C.</creator><creator>Banerjee, A.</creator><creator>Augustine, T.</creator><creator>Douglas, J.F.</creator><general>Blackwell Publishing Ltd</general><general>Oxford University Press</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>201607</creationdate><title>An ethical dilemma: malignant melanoma in a 51-year-old patient awaiting simultaneous kidney and pancreas transplantation for type 1 diabetes</title><author>Kirby, L. C. ; Banerjee, A. ; Augustine, T. ; Douglas, J.F.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4944-3febca8368d214c0a930ec9a0115fabe1eb39c9ee03ffd562c94ea5331dfcee23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Decision making</topic><topic>Diabetes mellitus (insulin dependent)</topic><topic>Diabetes Mellitus, Type 1 - complications</topic><topic>Diabetic Nephropathies - complications</topic><topic>Ethics</topic><topic>Graft rejection</topic><topic>Grafts</topic><topic>Humans</topic><topic>Immunosuppression</topic><topic>Kidney Failure, Chronic - complications</topic><topic>Kidney Failure, Chronic - surgery</topic><topic>Kidney transplantation</topic><topic>Kidney Transplantation - ethics</topic><topic>Kidney Transplantation - methods</topic><topic>Male</topic><topic>Medical ethics</topic><topic>Melanoma</topic><topic>Melanoma - complications</topic><topic>Middle Aged</topic><topic>Pancreas transplantation</topic><topic>Pancreas Transplantation - ethics</topic><topic>Pancreas Transplantation - methods</topic><topic>Skin cancer</topic><topic>Skin Neoplasms - complications</topic><topic>Transplants & implants</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kirby, L. C.</creatorcontrib><creatorcontrib>Banerjee, A.</creatorcontrib><creatorcontrib>Augustine, T.</creatorcontrib><creatorcontrib>Douglas, J.F.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of dermatology (1951)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kirby, L. C.</au><au>Banerjee, A.</au><au>Augustine, T.</au><au>Douglas, J.F.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>An ethical dilemma: malignant melanoma in a 51-year-old patient awaiting simultaneous kidney and pancreas transplantation for type 1 diabetes</atitle><jtitle>British journal of dermatology (1951)</jtitle><addtitle>Br J Dermatol</addtitle><date>2016-07</date><risdate>2016</risdate><volume>175</volume><issue>1</issue><spage>172</spage><epage>174</epage><pages>172-174</pages><issn>0007-0963</issn><eissn>1365-2133</eissn><abstract>Summary
Malignant melanoma is a high‐risk skin cancer that, in potential transplant recipients, is considered a substantial contraindication to solid organ transplantation due to significant risk of recurrence with immunosuppression. Current guidelines stipulate waiting between 3 and 10 years after melanoma diagnosis. However, in young patients with end‐stage organ failure and malignant melanoma, complex ethical and moral issues arise. Assessment of the true risk associated with transplantation in these patients is difficult due to lack of prospective data, but an autonomous patient can make a decision that clinicians may perceive to be high risk. The national and worldwide shortage of available organs also has to be incorporated into the decision to maximize the net benefit and minimize the risk of graft failure and mortality. The incidence of malignant melanoma worldwide is increasing faster than that of any other cancer and continues to pose ethically challenging decisions for transplant specialists evaluating recipients for solid organ transplantation.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>27484276</pmid><doi>10.1111/bjd.14554</doi><tpages>3</tpages></addata></record> |
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| ispartof | British journal of dermatology (1951), 2016-07, Vol.175 (1), p.172-174 |
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| source | MEDLINE; Oxford University Press Journals All Titles (1996-Current); Wiley Online Library All Journals |
| subjects | Decision making Diabetes mellitus (insulin dependent) Diabetes Mellitus, Type 1 - complications Diabetic Nephropathies - complications Ethics Graft rejection Grafts Humans Immunosuppression Kidney Failure, Chronic - complications Kidney Failure, Chronic - surgery Kidney transplantation Kidney Transplantation - ethics Kidney Transplantation - methods Male Medical ethics Melanoma Melanoma - complications Middle Aged Pancreas transplantation Pancreas Transplantation - ethics Pancreas Transplantation - methods Skin cancer Skin Neoplasms - complications Transplants & implants |
| title | An ethical dilemma: malignant melanoma in a 51-year-old patient awaiting simultaneous kidney and pancreas transplantation for type 1 diabetes |
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