De Novo Malignancy After Liver Transplant

Objectives: Patients who have liver transplant are at high risk of developing de novo malignancies. The purpose of this study was to evaluate incidence and histologic type of de novo malignancies after liver transplant in a liver transplant center. Materials and Methods: In 1700 patients who had orthotopic liver transplant from deceased and living donors from January 1992 to October 2012, de novo malignancies after transplant were analyzed. Results: There were 38 patients (2.2%) who developed de novo malignancy. Pathologic diagnosis was posttransplant lymphoproliferative disorder in 24 patients (63%), gastrointestinal adenocarcinoma in 4 patients (10%), Kaposi sarcoma in 3 patients (8%), pancreatic head adenocarcinoma in 2 patients (5%), papillary thyroid carcinoma in 1 patient (3%), lumbosacral multiple myeloma in 1 patient (3%), conjunctive carcinoma in 1 patient (3%), testicular cancer in 1 patient (3%), and metastatic adenocarcinoma to the vertebrae of unknown origin in 1 patient (3%). In the 24 patients who had posttransplant lymphoproliferative disorder, 20 patients (83%) were children aged < 10 years, and 5 patients (21%) died of this disease. Conclusions: Posttransplant lymphoproliferative disorder was the most common malignancy among liver transplant recipients. This disease primarily involved children and was a major cause of morbidity and mortality. Preventive and early diagnostic strategies are justified to decrease morbidity and mortality from de novo malignancy after liver transplant.