De novo primary liver cancer after liver transplantation: A French national study on 15 803 patients

Immunosuppression exposes recipients of liver transplant to de novo malignancies.1 However, few data are available regarding de novo primary liver cancer (PLC) and especially hepatocellular carcinoma (HCC). Indeed, interpretation of data is challenging as most PLCs after liver transplant are mainly recurrence of pretransplant cancer.2 As a result, only 14 cases of de novo HCC have been reported so far in the literature; 9/12 patients had recurrence of the initial liver disease associated with cirrhosis at time of HCC diagnosis and 8 patients died. In these 14 cases, 5 patients had hepatitis B virus, 3 had hepatitis C virus (HCV), 3 had HCV + alcoholism, 2 had alcoholic liver disease, and 1 had Budd-Chiari syndrome.