Keratinocyte Carcinoma Risk: Antithymocyte Globulin vs. Other Induction Therapy in Solid Organ Transplant Patients: A Meta-Analysis
- Journal
- Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] (Q2)
- Published
- 20 August 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Rishab Revankar, Urmila Sivagnanalingam, Mary Rojas, Christine Wu, Melissa Pugliano-Mauro
- PMID
- 42615813
- DOI
- 10.1097/DSS.0000000000005239
Why clinicians should know about it
- Picked for Dermatology (top studies of the week, 23 August 2026): Meta‑analysis of keratinocyte carcinoma risk in transplant patients
Abstract
BACKGROUND: Induction immunosuppression reduces early rejection after solid organ transplantation but may increase long-term malignancy risk, including keratinocyte carcinoma. Antithymocyte globulin is commonly used as a lymphocyte-depleting induction agent, yet its relative risk compared with other strategies remains unclear. OBJECTIVE: To evaluate the association between antithymocyte globulin induction therapy and keratinocyte carcinoma risk in adult solid organ transplant recipients compared with no induction, nondepleting agents, and other lymphocyte-depleting therapies. METHODS: PubMed, EMBASE, and MEDLINE were searched from January 1997 to February 2024. Observational studies and randomized trials reporting keratinocyte carcinoma outcomes in adult recipients exposed to antithymocyte globulin were included. Risk of bias was assessed using validated tools. Random-effects meta-analyses using risk ratios with 95% confidence intervals were performed. RESULTS: Twelve studies including 56,159 recipients with a weighted mean follow-up of 7.27 years were analyzed. Antithymocyte globulin induction was not associated with increased keratinocyte carcinoma risk compared with no induction. Lower risk was observed compared with alemtuzumab and OKT3. No significant difference in risk was observed compared with nondepleting anti-CD25 agents. CONCLUSION: Antithymocyte globulin induction does not increase keratinocyte carcinoma risk compared with no induction and is associated with lower risk than more potent lymphocyte-depleting agents after solid organ transplantation.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.