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Liver transplantation (LT) recipients such as all organ transplant recipients, have a risk of developing de novo malignancies owing to prolonged immunosuppression. However, there is limited data on this after living donor liver transplantation (LDLT), wherein immunosuppression levels are less than in deceased donor transplantation. We aim to describe experience of de novo malignancies from a predominantly LDLT center. A total of 2100 adults (age >18 years) who underwent LT between January 2006 and December 2017 were retrospectively analyzed from a prospectively collected database. The data were analyzed up to June 2019. Data are shown as number, percentage, mean ± standard deviation, and median (interquartile range). Of 2100 patients who underwent LDLT, 21 (1%) patients developed de novo malignancy after transplantation. The de novo malignancy cohort comprised 20 males and 1 female, aged 50 ± 8.8 years. The distribution of de novo malignancies was as follows: 7 oropharyngeal (carcinoma of buccal and oral mucosa), 4 lung, 2 squamous cell carcinoma of skin, 2 lymphoma, 1 each of brain, colonic, gastric; ovary, pancreatic, and prostate. These malignancies were diagnosed at a median follow-up of 42 months (32–73) after LT. Over a median follow-up of 38 months (10–56) after the diagnosis of de novo malignancy, 6 patients (28.5%) died. Patients with de novo malignancy had a higher follow-up after LDLT, 94.3 ± 32.9 versus 62.5 ± 41.8 months, P = 0.000. Patients with alcohol as etiology for LT had higher trend of de novo malignancies (33.3% versus 26.4%), P = 0.46. The incidence of de novo malignancy was 1% at a median follow-up of 42 (32–73) months. De novo malignancies following LDLT, although uncommon, are associated with significant mortality. A careful screening protocol should be followed after transplantation for early detection of de novo malignancies. [ABSTRACT FROM AUTHOR]

Highlights from the article: B Background and Aims: b Liver recipients like all organ transplant recipients, have a risk of developing denovo malignancies due to prolonged immunosuppression. B Results: b Of 1639 patients who underwent LDLT, 20 (1.22%) developed de novo malignancy after transplantation, among which 19 were males and 1 female. Of 20 de novo malignancies, 6 had oropharyngeal malignancy (carcinoma of oral and buccal mucosa), 4 lung cancer, 2 squamous cell carcinoma of skin, 2 lymphoma and 1 each had hepatoblastoma, bone tumor, carcinoma stomach; carcinoma ovary, pancreatic cancer and prostate cancer.