Tobacco use is associated with multiple medical problems including an increased risk of cancer (CA). The risk of CA is increased in the post-transplant period. This study is a retrospective chart review of a large number of liver transplant (LT) recipients to determine if a history of tobacco use is associated with incidence and type of post-transplant CA.
The records of 1315 consecutive liver transplant patients with a minimum of 6-months follow-up from 2001 to 2011 were reviewed (median 52 months). Patients were categorized as Current smoker, Previous smoker, or Never smoker (NS, n=684). Cox regression was utilized to evaluate long-term patient survival with covariates being MELD, recipient age, donor age and Hepatitis C diagnosis.
Current (n=291) and previous smokers (n=340) were more likely to have hepatocellular CA at transplant (26%, 29%, versus 19% (NS), p=0.001), and these two groups had higher recurrence rates (21%, 14%, versus were 11% (NS), p=0.18). De-novo non-HCC CA was higher for current and previous smokers, compared to NS (18%, 16%, versus 12%, p=0.05). Among those with de-novo CA (n=180), the two smoking groups were more likely to have non-skin CA (59%, 50% versus 23%, p<0.001). Patient survival at 10-years was much worse for current smokers than the other study groups (54% vs 70%, p<0.01).
These results demonstrate an increased risk in tobacco users for pre-transplant HCC, a higher recurrence rate for post-transplant HCC, and a higher risk of post-transplant de-novo CA. Smokers were more likely to have de-novo non-skin CA, compared to NS. Post liver transplant long term survival is significantly decreased in smokers.
To cite this abstract in AMA style:Bell J, Mangus R, Fridell J, Vianna R, Kubal C, Tiwari S, Tector A. Worse Long Term Patient Survival and Higher Cancer Rates in Liver Transplant Recipients with a History of Smoking [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/worse-long-term-patient-survival-and-higher-cancer-rates-in-liver-transplant-recipients-with-a-history-of-smoking/. Accessed May 7, 2021.
« Back to 2013 American Transplant Congress