De Novo Internal Neoplasms after Liver Transplantation: Increased Risk and Aggressive Behavior in Recent Years?
Article first published online: 25 FEB 2004
American Journal of Transplantation
Volume 4, Issue 4, pages 596–604, April 2004
How to Cite
Benlloch, S., Berenguer, M., Prieto, M., Moreno, R., Juan, F. S., Rayón, M., Mir, J., Segura, A. and Berenguer, J. (2004), De Novo Internal Neoplasms after Liver Transplantation: Increased Risk and Aggressive Behavior in Recent Years?. American Journal of Transplantation, 4: 596–604. doi: 10.1111/j.1600-6143.2004.00380.x
- Issue published online: 25 FEB 2004
- Article first published online: 25 FEB 2004
- Received 4 August 2003, revised and accepted for publication 30 November 2003
- de novo neoplasms;
- liver transplantation
The goal of the study was to determine the incidence and variables associated with post-liver transplantation (LT) de novo internal neoplasms development, excluding skin tumors and hepatocellular carcinoma. Medical records were reviewed for recipient/donor demographics, viral serology, cause of liver disease, interval from LT to tumor diagnosis, predisposing factors, immunosuppression and survival. Forty-one neoplasms (31 solid and 10 hematologic) developed in 772 recipients (5.3%) transplanted between 1991 and 2001. Time to tumor diagnosis was longer in patients transplanted before 1995 than in those transplanted afterwards (58 vs. 22 months; p < 0.05). Hematologic neoplasms (HN) appeared earlier than solid (2 vs. 21 months; p < 0.001), were more prevalent in those transplanted after 1995 than before (32% vs. 12.5%), and had lower survival than solid (2 vs. 21 months, p < 0.001). While HCV was the most frequent indication in HN (70%), alcohol was that of solid tumors (71%). Overall, risk factors for de novo neoplasms included alcohol and immunosuppression (p < 0.01). In patients undergoing LT in recent years, there is a higher incidence of HN with de novo internal neoplasms developing at earlier time-points than in those transplanted years ago. Risk factors for tumor development include alcohol, HCV and possibly strong immunosuppression.