Cancer common after liver transplantation

NEW YORK (Reuters Health) - People who undergo liver transplantation, particularly children, are at increased risk for developing cancer, Finnish researchers report in the journal Liver Transplantation.

“On the basis of our data,” Dr. Fredrik Aberg, from the Helsinki University Central Hospital, and co-authors note, “1 of 6 liver transplant patients is estimated to develop some form of cancer by 20 years after transplantation.”

Although post-transplant cancer are a recognized problem, “more studies are needed to obtain reliable data on cancer risk patterns in an attempt to reach consensus on optimal monitoring of (immune-suppressing drugs), cancer surveillance programs, and strategies to minimize cancer risk,” the authors maintain.

Their study included all 540 patients who received liver transplants at Aberg’s center between 1982 and 2005, linked with the nationwide Finnish Cancer Registry. During follow-up, 39 cancers developed in 36 patients, which translates into a 2.59-fold increased risk relative to that seen in the general population.

Rates were higher among children younger than 17 years of age than among older patients. The cancers developed anywhere from 4 months to 14 years after the transplant operation.

Further analysis showed that only non-Hodgkin lymphoma, a cancer of the body’s infection-fighting lymphatic system, and certain types of skin cancer were more common in liver transplant recipients than in the general population.

Risk factors for skin cancer were older age and the type of immune-suppressing drugs received, while those for non-Hodgkin lymphoma were male gender, young age, and the immediate post-transplant period.

Aberg’s team, “This study points out the importance of cancer surveillance after liver transplantation as well as the need for innovative immunosuppression strategies associated with less cancer risk.”

SOURCE: Liver Transplantation, October 2008.

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