Background: Solid organ transplant recipients are at increased risk for posttransplant neoplasms. Objective: Our purpose was to determine whether various diseases causing end- organ failure are associated with different degrees of risk of skin cancer development after transplantation. Methods: The Organ Procurement and Transplantation Network/United Network for Organ Sharing Transplant Tumor Registry was searched for the incidence of skin cancer among kidney, liver, and heart transplant recipients in the United States between 1996 and 2001. Multivariate analysis was used to determine the association between disease diagnosis and posttransplant skin cancer. Results: Transplant recipients with specific pretransplant diseases, such as polycystic kidney disease and cholestatic liver disease, were at increased risk for skin cancer. Patients with diabetesmellitus had a lower incidence of skin cancer after kidney transplantation. Limitations: The study had only a brief follow- up period, indirect assessment of photodamage, and possible underreporting. Conclusion: Transplant recipients with a history of certain diseases warrant intensive skin cancer surveillance and strict sun- protective practices. Background: Solid organ transplant recipients are at increased risk for posttransplant neoplasms. Objective: Our purpose was to determine whether various diseases causing end-organ failure are associated with different degrees of risk of skin cancer development after transplantation. Methods: The Organ Procurement and Transplantation. Network / United Network for Organ Sharing Transplant Tumor Registry was searched for the incidence of skin cancer among kidney, kidney, and heart transplant recipients in the United States between 1996 and 2001. Multivariate analysis was used to determine the association between disease diagnosis and posttransplant skin Results: Transplant recipients with specific pretransplant diseases, such as polycystic kidney disease and cholestatic liver disease, were at increased risk for skin cancer. Patients with diabetes mellitus had a lower incidence of skin cancer after kidney transplantation. Limitations: The study had only a brief follow- up period, indi rect assessment of photodamage, and possible underreporting. Conclusion: Transplant recipients with a history of certain diseases warrant intensive skin cancer surveillance and strict sun-protective practices.