Annals of Surgical Oncology

, Volume 20, Issue 11, pp 3582–3590 | Cite as

Liver Transplantation in Patients with Hepatitis B Virus-Related Hepatocellular Carcinoma: The Influence of Viral Characteristics on Clinical Outcome

  • Ting-Jung Wu
  • Kun-Ming Chan
  • Hong-Shiue Chou
  • Chen-Fang Lee
  • Tsung-Han Wu
  • Tse-Ching Chen
  • Chau-Ting Yeh
  • Wei-Chen Lee
Hepatobiliary Tumors



Hepatitis B virus (HBV) relapse and/or hepatocellular carcinoma (HCC) recurrence remains a major concern for patients who undergo liver transplantation (LT) because of HBV-related HCC. This study investigates the correlation between HBV relapse and HCC recurrence and it explores factors that affect patient outcomes after LT.


Between September 2002 and August 2009, 78 consecutive patients who underwent LT because of HBV-related HCC were enrolled in this study. Serum samples obtained before LT were assayed both for virological factors associated with HBV DNA and for genotypic characteristics of the virus. All patient clinicopathological features and virological factors were assessed further by univariate and multivariate analyses to determine prognostic factors.


During a median follow-up period of 29.4 months, 13 (16.6 %) patients experienced HCC recurrence and 18 (23.1 %) patients experienced HBV relapse. HBV relapse exhibited a close association with HCC recurrence (p = 0.004) and led to unfavorable overall survival after LT. Multivariate analysis of prognostic factors showed that the basal core promoter (BCP) mutation independently predicted a shorter survival period free from HBV relapse (p = 0.036). Moreover, with the exception of unfavorable tumor characteristics, the BCP mutation was found to be an important prognostic factor that affected HCC recurrence after LT (p = 0.042).


In this study, the HBV–BCP mutation was identified as an important predictor of post-LT clinical outcomes in patients with HBV-related HCC. Therefore, we recommend that aggressive antiviral treatment may be considered for patients associated with this risk factor.


Liver Transplantation Entecavir Basal Core Promoter Basal Core Promoter Mutation Virological Factor 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



This study was supported by grants from the Chang Gung Medical Research Program (CMRPG370693 and CMRPG3A1392) and from the National Science Council, Taiwan, R.O.C. (NMRP 98-2314-B-182A-048).


All authors declare no conflicts of interest for this study.

Supplementary material

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Copyright information

© Society of Surgical Oncology 2013

Authors and Affiliations

  • Ting-Jung Wu
    • 1
    • 4
  • Kun-Ming Chan
    • 1
  • Hong-Shiue Chou
    • 1
  • Chen-Fang Lee
    • 1
  • Tsung-Han Wu
    • 1
  • Tse-Ching Chen
    • 2
  • Chau-Ting Yeh
    • 3
  • Wei-Chen Lee
    • 1
  1. 1.Chang Gung Transplantation InstituteChang Gung Memorial Hospital at Linkou, Chang Gung University College of MedicineTaoyuanTaiwan
  2. 2.Department of PathologyChang Gung Memorial Hospital at Linkou, Chang Gung University College of MedicineTaoyuanTaiwan
  3. 3.Department of Hepato-Gastroenterology, Liver Research Center, Chang Gung Memorial Hospital at LinkouChang Gung University College of MedicineTaoyuanTaiwan
  4. 4.Graduate Institute of Clinical Medical SciencesChang Gung University College of MedicineTaoyuanTaiwan

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