Introduction : Patient and graft survival after liver transplantation(LT) have progressively improved in recent decades. Recurrent or de novo malignancy, however, remains one of the major cases of patient death after LT.  The following case describes a patient who develop de novo intrahepatic cholangiocarcinoma(IHCCC) in the graft liver after orthotic liver transplantation(OLT). To our knowledge, this is the first case of de novo IHCCC in a patient with hepatitis B related end stage liver disease after OLT,  although it has been reported in a patient with recurrent primary sclerosing cholangitis(PSC).

Methods : A 48-year-old male patient with end-stage liver disease (ESLD) from hepatitis B related liver cirrhosis and a MELD score of 26 was listed for LT. Recurrent esophageal
variceal hemorrhage, severe ascites, and splenomegaly had complicated his ESLD.

He underwent emergent whole organ, deceased donor liver transplant for liver cirrhosis. 
The donor liver was procured from a 72-year-old male who died of intracranial hemorrhage through standard donation after brain death process. The graft weight 1500 g and had normal color, and cold ischemia time was 5 hours upon arrival at our hospital. 


Results : His early post operative course was complicated by symptoms of cholangitis. Two months post-transplant, the patient visited emergency room for fever, abdominal pain and skin rash. CT scan showed a focal biliary stricture in the right hepatic duct. Magnetic

Conclusions : This is the first case of de novo IHCCC in a patient with hepatitis B related end stage liver disease after OLT,  although it has been reported in a patient with recurrent primary sclerosing cholangitis(PSC).