Introduction : The causes of death and mortality after organ transplantation are not well described in Korea and abroad. This study examined the causes of death and risk factors of death in the recipient after liver and kidney transplantation for 11 years.

Methods : Recipient of liver or kidney transplants were identified from National Health Insurance database between 2006 and 2017. Among 13,426 and 21,189 patients who received liver or kidney transplantation, 12,129 and 20,175 were included, excluding those who have transplanted more than once and multiorgan transplants.

Results : Overall, 2,398 deaths were observed after liver transplantation. Cancer deaths accounted for a majority of 1,135 (47.4%), of which 89.3% were caused by liver-related deaths. Part of immunosuppressive use after liver transplantation has been shown to increase the risk of death (Hazard ratio of sirolimus, azathioprine, prednisolone is more than 1). Of the 1,040 deaths after kidney transplantation, 361 (34.7%) deaths were attributable to renal‧urinary system followed by 126 (12.1%) of deaths from cancer. All immunosuppressive use of maintenance therapy after kidney transplantation increased the risk of death.

Conclusions : The causes of death after liver and kidney transplantation are different due to organ characteristics, but cancer remains the leading cause of death.