While immunosuppressive agents are necessary to prevent the rejection of transplanted organs, and are a great\nmedical success story for protecting against early allograft loss, graft and patient survival over the long term are\ndiminished by side effects from these same drugs. One striking long-term side effect is a high rate of skin cancer\ndevelopment. The skin cancers that develop in transplant recipients tend to be numerous, as well as particularly\naggressive, and are therefore a major contributor to morbidity and mortality in transplant recipients. An apparent\nreason for the high incidence of skin cancer likely relates to suppression of immune surveillance mechanisms, but\nother more direct effects of certain immunosuppressive drugs are also bound to contribute to cancers of UV-exposed\nskin. However, over the past few years, evidence has emerged to suggest that one class of immunosuppressants,\nmammalian target of rapamycin (mTOR) inhibitors, could potentially inhibit skin tumour formation through a number\nof mechanisms that are still being studied intensively today. Therefore, in light of the high skin cancer incidence in\ntransplant recipients, it follows that clinical trials have been conducted to determine if mTOR inhibitors can significantly\nreduce these post-transplant skin malignancies. Here, the problem of post-transplant skin cancer will be briefly\nreviewed, along with the possible mechanisms contributing to this problem, followed by an overview of the relevant\nclinical trial results using mTOR inhibitors.
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