The transplantation of organs from donors who have undergone shunt surgery or craniotomy for a malignant central nervous system (CNS) tumor is controversial. We report a case of Kaposi's sarcoma (KS) developing as a result of immunosuppression in the recipient of a liver transplant from a donor who underwent craniotomy and ventriculoperitoneal shunt surgery for primary CNS lymphoma. Polymerase chain reaction assay did not isolate human herpes virus-8 in the Kaposi lesions. To our knowledge, this is the only case ever reported of KS developing after liver transplantation from a donor with lymphoma. Thus, with appropriate screening to exclude possible dissemination, patients with a history of high-grade primary CNS lymphoma treated by ventriculoperitoneal shunt and craniotomy may be accepted as donors.