Increased cancer risk after liver transplantation: a population-based study

Background/Aims: Development of de novo malignancies emerges as a serious long term complication after liver transplantation. Methods: We reviewed the medical records of 174 adult one-year survivors for de novo malignancies, The observed cancer rates were compared with the expected cancer rates in the Dutch population. Results: Twenty-one of the 174 patients developed 23 malignancies (12%). Skin and lip cancer accounted for 12 of the 23 malignancies (52%). Only one patient had a B-cell lymphoma. The cumulative risk for de novo malignancy was 6, 20, and 55% at 5, 10, and 15 years after transplantation, respectively, The overall relative risk (RR) as compared with the general population was 4.3 (95% confidence interval 2.4-7.1), Significantly increased RRs were observed for nonmelanoma skin cancer (RR 70.0), non-skin solid cancer (RR 2.7), renal cell cancer (RR 30.0), and colon cancer (RR 12.5), Multivariate analysis showed that an age > 40 years and pretransplant use of immunosoppression were significant risk factors. Conclusions: An increased risk of cancer exists after liver transplantation, for both for skin/lip cancer, and other solid tumors. Older age and the use of immunosuppression are risk factors. (C) 2001 European Association for the Study of the Liver. Published by Elsevier Science B.V. All rights reserved.