Organ transplant recipients are considered to be at greater risk for developing
malignancy because of the prolonged immunosuppression associated with
organ grafting. The purpose of this study is to determine risk factors, clinical characteristics, and outcomes of de novo nonlymphoid
malignancies after
liver transplantation from a large single-center series. All patients undergoing
liver transplantation at the King's College Hospital (London, UK) between January 1988 and December 1999 were analyzed retrospectively for the development of de novo
malignancy in the posttransplantation period. Records were evaluated for age at diagnosis of
malignancy, cause of
liver disease, interval from
transplantation to diagnosis of
malignancy, predisposing factors for the development of
cancer, immunosuppression regimen, treatment of
malignancy, rejection episodes, and patient survival. Of 1,140 patients undergoing 1,271
liver transplantations, 30 patients (2.6%) developed de novo nonlymphoid
malignancy after
transplantation.
Skin cancers were the most common (n = 13), followed by oropharyngeal
carcinoma (n = 2), bladder
carcinoma (n = 2), acute
leukemia (n = 2),
breast carcinoma (n = 2), and various other
malignancies (n = 9). The mean time of presentation of the
malignancy after
transplantation was 45.1 +/- 32 months (range, 6 to 133 months), and mean age at diagnosis of
malignancy was 55 years (range, 34 to 71 years). The incidence of de novo
malignancy was significantly greater in patients who underwent
transplantation for
alcoholic liver disease compared with other groups (P <.001). Although the incidence of de novo nonlymphoid
malignancy after
liver transplantation is low, patients who underwent
transplantation for
alcoholic cirrhosis appear to have an increased risk for developing posttransplantation
malignancy.