The aims of this analysis are to characterize the incidence and types of
malignancies and
tumor-specific mortality in our institution. Retransplantation, rejection episodes, and
OKT3 use were evaluated. Our single-institution prospective database of 1,570
liver transplantations in 1,421 patients was analyzed. Data were statistically analyzed regarding sex, age at
transplantation, time from
transplantation to diagnosis of
tumor,
tumor type, and follow-up time. One hundred twenty-five patients (8.8%) developed de novo
tumors; 69 patients were men, 56 patients were women. Seventeen patients received more than one allograft. De novo
tumors were as follows: skin, 41;
lymphomas, 35; lung, 11; colon, 6; anal, 2; rectal, 1; breast, 7; thyroid, 3; oropharyngeal squamous cell, 3; metastatic without primary
tumor identified, 4; renal cell, 3;
Kaposi's sarcoma, 1;
angiosarcoma, 1; uterine, 1; ovarian, 1; pituitary, 1; pancreatic, 2;
cholangiocarcinoma, 1; and esophageal, 1. These
tumors developed in a statistically significant chronological sequence.
Lung cancers and
lymphomas showed shorter mean survival times, as well as greater mortality.
OKT3 use and rejection did not show significance in
tumor development. De novo
tumors post-
liver transplantation affected our population in a distribution similar to that of the general non-
transplantation population. Intense short courses of immunosuppression for rejection were not as important as chronic immunosuppression in the development of
tumors. The risk for development was not enough to preclude
transplantation. We found that
tumors developed in chronological fashion. Therefore, directed surveillance, patient education, and early detection may facilitate earlier treatment.