Background and aims: De novo malignancies are one of the major late complications and cause of death after liver transplantation (LT). Using extensive data from the “French National Agence de la Biomédecine Cristal database”, the present study aimed to quantify the risk of solid organ de novo malignancies (excluding non-melanoma skin cancers) after LT.

Methods: The incidence of de novo malignancies among all LT patients between 1993 and 2012 was compared to that of the French population, standardized on age, gender, and calendar period (standardized incidence ratio, SIR). Patients with history of malignancy before LT were not included.

Results: Among the 11226 liver transplant patients included in the study, 1200 de novo malignancies were diagnosed (11.6%) after a median delay of 5.0 years after LT. The risk of death was approximately two times higher in patients with de novo malignancy (48.8% vs. 24.3%). The SIR for all de novo solid organ malignancies was 2.20 (95%CI [2.08-2.33]). The risk was higher in men (SIR=2.23, 95%CI [2.09-2.38]), and in patients transplanted for alcoholic liver disease (SIR=2.89, 95%CI [2.68-3.11]). The cancers with the highest excess risk were laryngeal (SIR=7.57, 95%CI [5.97-9.48]), esophageal (SIR=4.76, 95%CI [3.56-6.24]), lung (SIR=2.56, 95%CI [2.21-2.95]) and lip-mouth pharynx (SIR=2.20, 95%CI [1.72-2.77]). Women transplanted for ALD had a massive significant excess risk of cancer of larynx (SIR=61.05, 95%CI [29.28-112.28]), esophagus (SIR=38.58, 95%CI [17.18-71.33]) and lip-mouth-pharynx (SIR=14.25, 95%CI [7.79-23.91]).

Conclusions: LT recipients have an increased risk of de novo solid organ malignancies and this is strongly related to alcoholic liver disease as a primary indication for LT.

CITATION INFORMATION: Seree O., Altieri M., Dumortier J., GReF2 Long-Term Risk of Solid Organ De Novo Malignancies after Liver Transplantation: A French National Study on 11226 Patients Am J Transplant. 2017;17 (suppl 3).

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