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Recurrent Hepatocellular Carcinoma in Liver Transplant Recipients with Hepatitis C

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Abstract

Purpose

Hepatitis C (HCV) is the most common liver disease in patients transplanted with hepatocellular carcinoma (HCC) in the West. We examined predictors of HCC recurrence in liver transplant recipients with HCV.

Methods

From 1997 to 2006, 53 patients with HCC and HCV underwent liver transplantation. Pre-and post-operative data (including liver biopsies 4 months post-transplant) were collected. Differences between HCC recurrence and non-recurrence groups were detected by Student’s t test or chi-square test. Data were analyzed as predictors of HCC recurrence by logistic regression multivariate analysis. Cumulative survival was analyzed by Kaplan–Meier curves and compared by the log-rank test.

Results

Eleven of 53 patients (20.8%) developed HCC recurrence at a median interval of 15 months (2 to 55 months). Median Histology Activity Index (HAI) of liver biopsies, AST, and ALT at 4 months were significantly greater in patients with HCC recurrence. Independent predictors of HCC recurrence were HAI ≥ 4 at 4 months, ALT ≥ 100 at 4 months, and vascular invasion. Patients with HCC recurrence had significantly decreased survival.

Conclusions

In this preliminary study, Histology Activity Index and ALT at 4 months, as well as vascular invasion, predicted HCC recurrence in liver transplant recipients with HCV.

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Acknowledgments

The authors have no source of funding to report.

Conflicts of interest

No conflicts of interest exists for any of the authors.

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Authors and Affiliations

  1. Section of Transplantation in the Department of Surgery, University of Utah School of Medicine, 30 North 1800 East, SB110 SOM, Salt Lake City, UT, 84132, USA

    Jason J. Schwartz, John B. Sorensen & Robin D. Kim

  2. Division of Transplantation in the Department of Surgery, University of Florida College of Medicine, Jacksonville, FL, USA

    Ivan Zendejas-Ruiz

  3. Division of Transplantation in the Department of Surgery, University of California San Diego, San Diego, CA, USA

    Alan W. Hemming

  4. Division of Hepatology in the Department of Medicine, University of Florida College of Medicine, Jacksonville, FL, USA

    Chaoru Chen

Authors
  1. Ivan Zendejas-Ruiz
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  2. Alan W. Hemming
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  3. Chaoru Chen
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  4. Jason J. Schwartz
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  5. John B. Sorensen
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  6. Robin D. Kim
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Correspondence to Robin D. Kim.

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Zendejas-Ruiz, I., Hemming, A.W., Chen, C. et al. Recurrent Hepatocellular Carcinoma in Liver Transplant Recipients with Hepatitis C. J Gastrointest Canc 43, 229–235 (2012). https://doi.org/10.1007/s12029-010-9230-4

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  • DOI: https://doi.org/10.1007/s12029-010-9230-4

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