Keratinocyte carcinoma (KC) defined as squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) is the most common malignancy among non-Hispanic white (NHW) renal transplant recipients (RTRs). While recent genome-wide association studies reported that the class II human leukocyte antigen (HLA) is associated with KC risk, epidemiologic data on HLA type and KC risk in RTRs is limited. Using an institutional cohort of NHW RTRs transplanted between 1993-2017, we examined the association between pre-transplant molecular HLA types and KC risk. Post-transplant KCs were captured using the International Classification of Diseases codes and validated using pathology reports. Cox proportional hazards regression models were used to estimate hazard ratios (HR) of incident KC, SCC and BCC, adjusting for age, male, history of KC, Charlson comorbidity index, HLA mismatch, transplant type, year of transplant, and the type of immunosuppression. Among 617 subjects (mean age 53 years,67% male), 10% developed post-transplant KC. Multivariable Cox regression analyses showed HLA-DRB1*13 was associated with KC risk (HR 1.84, 95% CI 1.00-3.38) and SCC risk (HR 2.24, 95% CI: 1.12-4.49), while HLA-DRB1*14 (HR 2.81, 95% CI: 1.14-6.91) was associated with BCC risk. Our findings suggest that a subset of RTRs with specific HLA polymorphisms may be at increased KC risk.
J. Invest. Dermatol.
Association between human leukocyte antigen type and keratinocyte carcinoma risk in renal transplant recipients.