De novo malignancies after liver transplantation (LT) are one of the leading causes of late mortality, with a reported risk of malignancies twice as high as the general population. The aim of the present study was to study predictive factors of de novo malignancies in a large cohort of LT recipients in France.

This population-based cohort study included all adult patients who underwent a first LT in France from January 1, 2000 to December 31, 2013. For cancer, an extension of the Cox model adapted to the identification of predictive factors in a context of competitive risks was used.

The study cohort included 11004 adult transplant recipients between 2000 and 2013 who had never had pre-transplant cancer except HCC. From the entire cohort, one (or more) de novo malignancy was reported in 1480 LT recipients (13.45%).

The median age of patients without malignancy was 53.8 years, and the median age of patients with malignancy was 54.2 years. The median (interquartile) duration of follow-up was 3.55 (1.04-7.18) years for patients with no malignancy and 3.59 (1.10-7.04) years for patients developing malignancy. LTs performed with an alcoholic cirrhosis aetiology accounted for 38.8% of LT causes in cancer patients versus 31.8% in TH that did not develop cancer. We observed a significant increase in risk of cancer Subdistribution Hazard Ratio (SHR) = 1.03 and Death Hazard Ratio (HR) = 1.02 with age. Women have a significantly lower risk of reporting post LT cancer. The initial diseases Alcoholic cirrhosis, autoimmune, other cirrhosis and hepatic tumours have a significantly higher risk of developing cancer. Regarding treatments, there is no significant difference between the different treatments of each class on the occurrence of de novo cancer. Regarding treatments, there is no significant difference between the different treatments of each class on the occurrence of de novo cancer.

In conclusion, age, sex, OH cirrhosis, autoimmune disease, other cirrhosis, and hepatic tumor of TH were risk factors of post-LT de novo malignancies and age, sex, metabolic disease, anti-cell antibodies and retransplantations were associated with poorer survival.

CITATION INFORMATION: Altieri M., Seree O., Dumortier J., GREF2 Groupe de Recherche Français en Greffe de Foie Risk Factors of De Novo Malignancies after Liver Transplantation Am J Transplant. 2017;17 (suppl 3).

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