Malignancy After Living Donor Liver Transplantation

Area of Science:

• Hepatology and Transplant Surgery
• Oncology
• Immunology

Background:

• De novo malignancy (DNM) is a significant cause of mortality in long-term liver transplant (LT) recipients.
• Living-donor LT (LDLT) is an alternative for patients awaiting deceased-donor organs, but DNM risk requires investigation.

Purpose of the Study:

• To report the incidence, characteristics, and outcomes of de novo malignancy (DNM) in adult recipients following living-donor liver transplantation (LDLT).
• To identify risk factors and prognostic indicators for DNM after LDLT.

Main Methods:

• Retrospective analysis of 70 adult LDLT recipients surviving >1 year from 1999-2022.
• Follow-up for de novo malignancy development, cancer type, treatment, and survival.

Main Results:

• Eight DNMs occurred in 7 recipients (lung cancer, post-transplant lymphoproliferative disease, skin cancer).
• Pre-LT smoking history was a significant risk factor (P=.004).
• Cumulative DNM incidence reached 18.4% at 20 years; DNM patients had worse survival (P=.049).

Conclusions:

• De novo malignancy (DNM) after LDLT is associated with reduced survival.
• Pre-transplant smoking is a risk factor for DNM.
• R0 resection is crucial for improving prognosis; regular cancer screening is recommended for early detection.