Introduction: The aim of this study is to evaluate the incidence of De Novo malignancies including skin cancers in patients with liver transplantation in Shiraz organ transplant center. Patients who undergo solid organ transplant are at high risk for development of hepatic and extrahepatic malignancies. Environmental factors, genetic predisposition, and immunosupression are among the predisposing factors for De Novo malignancies.

Materials and Methods: A total of 1550 orthotopic liver transplants from deceased and living donors performed from 1992 to march 2012 were analyzed. The immunosuppressive regimen included of calcineurin inhibitors with steroids with or without mycophenolate mofetil.

Results: Among 1550 patients, 30 (1.93%) cases developed malignancies. 19 patients (63.3%) developed PTLD, in whom 17 patients were pediatric (<18 years of age). Among PTLD patients, 5 expired in spite of diagnosis and treatment. Other malignancies were as follows: 3 cases of gastric adenocarcinoma, 2 cases of Kaposi sarcoma, 1 thyroid cancer, 1 Lumbosacral multiple myeloma, 1 intestinal adenocarcinoma, 1 pancreatic head adenocarcinoma, 1 testicular cancer and 1 retinal carcinoma.

Conclusions: PTLD is the most common cancer among our patients after liver transplantation which involved mostly children. Interestingly, there was no skin cancer in our patients, while skin cancers constitute the most common malignancy following liver transplantation in other centers. More studies are necessary to identify the cause of this discordance.