Taking Steps to Promote Posttransplant Survivorship Through Preventative Care

Saro Armenian, DO, MPH, chair of the Department of Pediatrics and director of the Division of Outcomes Research in the Department of Population Sciences at City of Hope, emphasizes that integrating targeted screening routines into long-term follow-up care for hematopoietic stem cell and solid organ transplant survivors represents a low-cost, high-impact clinical investment. Because transplant recipients face elevated risks for late-onset complications stemming from both conditioning therapies and underlying genetic predispositions, taking a proactive approach to survivorship care significantly improves survivorship outcomes. Although transplant survivors typically comprise a small proportion of any general oncology or primary care practice, dedicating time to identify individualized risk profiles yields substantial long-term dividends.

Implementing specialized, risk-adapted screening allows clinicians to shift care from reactive disease management to early detection and prevention. This model fundamentally transforms lives through minimal resource expenditure. A prime example of a highly efficient, scalable intervention is routine skin cancer surveillance. Armenian says that every transplant survivor should undergo a comprehensive skin examination at least once per year. The assessment requires only a few minutes during routine follow-up visits, creating minimal disruption to clinical workflow. Early detection of post-transplant cutaneous malignancies, such as squamous cell carcinoma or melanoma, allows for prompt, definitive intervention.

Armenian underscores that establishing annual skin screenings is a moral imperative in modern posttransplant care. Historically, options for managing advanced secondary cutaneous malignancies in immunocompromised populations were limited. However, modern therapeutic advances including immune checkpoint inhibitors and targeted, less-toxic systemic agents provide highly effective, well-tolerated treatment options when lesions are identified early. By embedding brief, structured screening protocols into posttransplant care pathways, providers can prevent irreversible disease progression, maximize the curative potential of modern therapies, and safeguard long-term functional survival for transplant recipients.