Korean J Transplant.  2020 Dec;34(Supple 1):S155. 10.4285/ATW2020.PO-1116.

Pretransplant hepatic malignancy increases risk of de novo malignancy after liver transplantation

Affiliations
  • 1Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

Abstract

Background
Hepatocellular carcinoma (HCC) recurrence and development of de novo malignancy (DNM) after liver transplantation (LT) are the major causes of late recipient death.
Methods
We analyzed the incidence of extrahepatic DNM following living donor LT according to the status of pretransplant hepatic malignancy. We selected 2,076 adult patients who underwent primary LDLT during 7 years from January 2010 to December 2016.
Results
The pretransplant hepatic malignancy group (n=1,012) showed 45 cases (4.4%) of the following extrahepatic DNMs: posttransplant lymphoproliferative disease (PTLD) in 10; lung cancer in 10; stomach cancer in six; colorectal cancer in five; urinary bladder cancer in three; and other cancers in 11. The pretransplant no hepatic malignancy group (n=1064) showed 25 cases (2.3%) of the following extrahepatic DNMs: colorectal cancer in three; stomach cancer in three; leukemia in three; lung cancer in three; PTLD in two; prostate cancer in two; and other cancers in nine. Incidences of extrahepatic DNM in the pretransplant hepatic malignancy and no hepatic malignancy groups were as follows: 1.1% and 0.5% at 1 year, 3.2% and 2.0% at 3 years, 4.6% and 2.5% at 5 years, and 5.4% and 2.8% at 8 years, respectively (P=0.006). Their overall patient survival rates were as follows: 97.3% and 97.2% at 1 year, 91.6% and 95.9% at 3 years, 89.8% and 95.4% at 5 years, and 89.2% and 95.4% at 8 years, respectively (P<0.001). Pretransplant hepatic malignancy was the only significant risk factor for posttransplant extrahepatic DNM.
Conclusions
Our results suggest that patients who had pretransplant hepatic malignancy be followed up more strictly because they have a potential risk of primary hepatic malignancy recurrence as well as a higher risk of extrahepatic DNM than patients without pretransplant hepatic malignancy.

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