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Effect of HBV-HDV co-infection on HBV-HCC co-recurrence in patients undergoing living donor liver transplantation

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Abstract

Purpose

To evaluate the effect of hepatitis D virus (HDV) on hepatitis B virus-hepatocellular carcinoma (HBV-HCC) co-recurrence in patients undergoing living donor liver transplantation (LDLT) for HBV alone or HBV-HDV coinfection.

Methods

Between 2002 and 2019, 254 HBV-HCC patients underwent LDLT. The patients were divided into two groups after the application of the exclusion criteria: HBV-HCC (Group B; n = 163) and HBV-HDV-HCC (Group D; n = 31). First, the B and D groups were compared in terms of demographic and clinical parameters. Second, patients with (n = 16) and without (n = 178) post-transplant HBV-HCC co-recurrences were grouped and compared in terms of the same parameters.

Results

Although the risk of HBV-HCC co-recurrence in group D was 4.99-fold higher than in group B, the risk of HBV recurrence alone in group D was 12.5-fold lower than in group B. The AFP (OR = 4.4), Milan criteria (beyond; OR = 18.8), and HDV (OR = 8.1) were identified as the independent risk factors affecting post-transplant HBV-HCC co-recurrence. The Milan criteria (OR = 2.1) and HBV-HCC co-recurrence (OR = 10.9) were identified as the risk factors affecting post-transplant mortality. HBV-HCC co-recurrence developed in 26.5% of patients in Group B and 100% in Group D (OR = 40; p = 0.001). HCC recurrence alone developed in 10% of patients without HBV recurrence in group B and 0% of patients without HBV recurrence in group D (OR = 5.7).

Conclusion

This study showed that the risk of HBV recurrence alone was reduced by 12.5-fold in the presence of HDV; however, the HCC recurrence occurred in all patients with HDV when HBV recurrence developed.

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Authors and Affiliations

  1. Department of Surgery, Faculty of Medicine, Liver Transplant Institute, Inonu University, Elazig Yolu 10. Km, 44280, Malatya, Turkey

    Adil Baskiran, Sami Akbulut, Tevfik Tolga Sahin, Cemalettin Koc, Serdar Karakas, Volkan Ince & Sezai Yilmaz

  2. Department of Gastroenterology, Faculty of Medicine, Koc University, 34450, Istanbul, Turkey

    Cihan Yurdaydin

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  1. Adil Baskiran
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  2. Sami Akbulut
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Corresponding author

Correspondence to Sami Akbulut.

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Conflict of interest

Adil Baskiran, Sami Akbulut, Tevfik Tolga Sahin, Cemalettin Koc, Serdar Karakas, Volkan Ince, Cihan Yurdaydin, and Sezai Yilmaz declare that they have no conflict of interest.

Ethical approval

This study was approved by the Inonu University Institutional Review Board for Non-interventional Studies (Approval No: 2020/760).

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Baskiran, A., Akbulut, S., Sahin, T.T. et al. Effect of HBV-HDV co-infection on HBV-HCC co-recurrence in patients undergoing living donor liver transplantation. Hepatol Int 14, 869–880 (2020). https://doi.org/10.1007/s12072-020-10085-3

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  • DOI: https://doi.org/10.1007/s12072-020-10085-3

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