A Case of Cutaneous Kaposi Sarcoma in a Patient Post-Heart Transplantation

Although patients with solid organ transplants have a higher risk of developing Kaposi sarcoma (KS), the data on KS post-heart transplantation are sparse.

We present a case of a 69-year-old man with a history of heart transplantation for ischemic cardiomyopathy who developed violaceous skin lesions 5 months after transplant, with a skin biopsy confirming human herpesvirus-8-positive KS. Given no extracutaneous involvement, he was managed with a modification in his immunosuppressive regimen, with initiation of sirolimus and reduction in his tacrolimus dosage, as well as with topical imiquimod and local radiation.

Although KS in other solid organ transplants, namely kidney, has been well documented, guidance on how to manage KS in post-heart transplant is lacking.

This case illustrates that a mammalian target of rapamycin inhibitor-based immunosuppressive regimen and locoregional therapy may be an effective strategy to manage post-heart transplantation cutaneous KS.