Risk factors for development of de novo neoplasia after liver transplantation

Liver transplant recipients are at greater risk for de novo neoplasia, espe cially lymphoma and nonmelanoma skin cancer; however, risk factors for this complication have not been well studied. Clinical and pathological records of 137 consecutive liver transplant recipients who had survived for at lea st 1 year were reviewed to register de novo neoplasia. Ten variables were a nalyzed for their association with the development of de novo malignancies by means of a log-rank test and stepwise selection in a multivariate analys is using the Cox proportional hazard model. Thirty de novo neoplasias appea red in 22 of 137 transplant recipients between 12 and 104 months after orth otopic liver transplantation (OLT; median follow-up, 69 months): 14 patient s had 21 skin cancers, 6 patients had solid-organ cancer, and 3 patients de veloped a lymphoproliferative disease. Probabilities of de novo neoplasia w ere 13% at 5 years post-OLT and 26% at 8 years post-OLT. The only associate d risk factor for any neoplasia was age. Age and hepatocarcinoma were indep endent risk factors associated with skin cancer. That hepatocarcinoma in th e explanted liver is an independent risk factor for skin cancer suggests th ere is individual susceptibility to both neoplasias.