Abstract: SA-PO1073
Photodynamic Therapy for the Prevention and Treatment of Actinic Keratoses/Squamous Cell Carcinoma in Kidney Transplant Recipients: Systematic Review
Session Information
- Transplantation: Clinical - Postkidney Transplant Outcomes and Potpourri
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Saeed, Muhammad Ramish, King Edward Medical University, Lahore, Punjab, Pakistan
- Saeed, Tanzeela Sameen, Services Institute of Medical Sciences, Lahore, Punjab, Pakistan
- Abdullah, Muhammad Fahad, Allama Iqbal Medical College, Lahore, Punjab, Pakistan
- Najafi, Syed Muhammad Ali, Services Institute of Medical Sciences, Lahore, Punjab, Pakistan
- Qureshi, Muhammad Shoaib, King Edward Medical University, Lahore, Punjab, Pakistan
- Safdar, Malik Ahsan, Services Institute of Medical Sciences, Lahore, Punjab, Pakistan
- Shafqat, Aymen, Services Institute of Medical Sciences, Lahore, Punjab, Pakistan
- Chowdhury, Mirza Farhana Iqbal, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
- Saeed, Armeen, Allama Iqbal Medical College, Lahore, Punjab, Pakistan
Background
Renal transplant recipients (RTRs) are at high risk for actinic keratoses (AK) and squamous cell carcinoma (SCC) due to prolonged immunosuppression. Photodynamic therapy (PDT) is a non-invasive treatment with potential for managing and preventing these lesions. This systematic review evaluated the clinical efficacy, safety, tolerability, and cosmetic outcomes of PDT in this high-risk group.
Methods
A comprehensive search of PubMed, Embase, ClinicalTrials.gov, and Cochrane Library was conducted for studies published up to April 2025. Eligible studies included RCTs, prospective cohorts, and case series assessing PDT for AK/SCC in RTRs. PRISMA guidelines were followed, and only English-language human studies were included. Key outcomes were complete response rates (CRR), prevention of new lesions, recurrence rates, adverse events, and cosmetic outcomes.
Results
Seven studies met the inclusion criteria: three RCTs, one single-arm trial, and three cohort/case series. Five studies assessed treatment efficacy, with CRRs from 71% to 100%. Two RCTs evaluated prevention and showed reduced new lesion incidence with regular PDT use. Three studies reported recurrence rates (15–48%) over 6–12 months. All studies noted adverse events, primarily pain during illumination. Daylight and low-irradiance PDT showed better tolerability. In four studies, cosmetic outcomes were rated good to excellent, especially for facial lesions, with minimal scarring.
Conclusion
PDT is an effective, well-tolerated option for treating and preventing AK/SCC in RTRs, offering high clearance rates, reduced new lesions, and strong cosmetic results. Despite small sample sizes and protocol variability, findings support PDT’s role in dermatologic care for RTRs at high skin cancer risk.
Outcomes from Included Studies
| Study | Study Design | Complete Response Rate (CRR) | Recurrence Rate | Prevention Outcome | Adverse Events | Cosmetic Outcomes |
| Dragieva et al. | Prospective Case Series | 86% at 4 weeks (↓ to 52% at 48 weeks) | 48% at 1 year | Not applicable | Moderate–severe pain, erythema | Good |
| Piaserico et al. | Prospective Case Series | 71% | Not specified | Not applicable | Pain in 47%, no systemic AEs | Good |
| Perrett et al. | Randomized Controlled Trial | 78% | 15% at 6–12 months | Not applicable | Mild pain, erythema | Good–Excellent |
| González-Guerra et al. | Prospective Interventional | 75–100% lesion clearance | Not reported | Not applicable | Mild pain, erythema (well tolerated) | Excellent |
| NCT01000636 | Single-arm Clinical Trial | 95.5% mean lesion reduction | Not reported | Not applicable | Mild pain, no systemic AEs | Not reported |
| Wulf et al. | Randomized Controlled Trial | Not applicable | Not applicable | 53% reduction in new AKs | Mild erythema, well tolerated | Not reported |
| Togsverd-Bo et al. | Randomized Controlled Trial | Not applicable | Not applicable | 28% vs. 63% new lesion rate (treated vs. control) | 2 phototoxic reactions, well tolerated | Not reported |