Higher cumulative exposure to tacrolimus in the first year after liver transplant has been linked to a higher risk for de novo malignancies and recurrent liver cancer in a case-control study.

Researchers at 16 transplant centres in Spain studied nearly 3000 patients who underwent liver transplantation between 2010 and 2015 and were treated with tacrolimus, including 491 (19.7%) who developed cancer during a median follow-up of 65 months.

Incidence rates were 3.5/100 person-years for all type of tumours and 2.6/100 person-years for de novo cancers.

After controlling for liver cancer, risk factors for post-transplant malignancy included age greater than 50 at transplant, male gender, active smoking and alcoholic liver disease, the researchers reported.