The impact of waiting list alpha-fetoprotein changes on the outcome of liver transplant for hepatocellular carcinoma.


BACKGROUND & AIMS:Liver transplantation is a recognized treatment for selected patients with hepatocellular carcinoma (HCC), but transplant criteria still need to be refined, especially in the case of more advanced or downstaged tumors. METHODS:The present study investigated alpha-fetoprotein (AFP) as a predictor of outcome in 6817 patients listed with a diagnosis of HCC in the Scientific Registry of Transplant Recipients. RESULTS:Local pre-transplant HCC treatment was used in 41% of patients on the waiting list. Patients with AFP levels>400 ng/ml at the time of listing who were downstaged to AFP ≤400 ng/ml had better intent-to-treat survival than patients failing to reduce AFP to ≤400 (81% vs. 48% at 3 years, p ≤0.001) and comparable survival to patients with stable AFP ≤400 ng/ml (74%, p = 0.14). Patients with AFP levels decreased ≤400 ng/ml and patients with levels persistently ≤400 ng/ml also had similar drop-out rates from the list (10% in both groups) and post-transplant survival rates (89% vs. 78% at 3 years, p = 0.11). Such an AFP downstaging was associated with good survivals whatever the level of the original AFP (even if originally>1000 ng/ml). Only the last pre-transplant AFP independently predicted survival (p ≤0.001), unlike AFP at listing or AFP changes. CONCLUSIONS:Overall, downstaging HCC patients with high AFP is feasible and leads to similar intent-to-treat and post-transplant survivals to those of patients with AFP persistently low. Only last AFP appears relevant for patient selection before transplantation and should be used in combination with morphological variables.


J Hepatol


Journal of hepatology


Merani S,Majno P,Kneteman NM,Berney T,Morel P,Mentha G,Toso C




Has Abstract


2011-10-01 00:00:00














  • Cytotoxic T-cell responses to the nucleocapsid proteins of HBV in chronic hepatitis. Evidence that antibody modulation may cause protracted infection.

    abstract::The nucleocapsid antigens (HBc and HBe) are present on the membranes of HBV-infected hepatocytes from HBV carriers. In autologous cytotoxicity experiments we demonstrate that cytotoxic T cells sensitised to the nucleocapsid proteins of hepatitis B are present in HBe antigen-positive HBV carriers with chronic hepatitis...

    journal_title:Journal of hepatology

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  • Antitumor effect of the nucleoside analogs 2-chlorodeoxyadenosine and 2',2'-difluorodeoxycytidine on human hepatoma HepG2 cells.

    abstract:BACKGROUND/AIMS:Hepatocellular carcinoma is one of the most malignant tumors in the world. Although a wide range of therapeutic options is available, the efficacy of these methods and the prognosis of hepatocellular carcinoma are still very poor. The nucleoside analogs 2-chlorodeoxyadenosine (Cladribine, 2-CdA) and 2',...

    journal_title:Journal of hepatology

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  • Hepatic stellate cell autophagy inhibits extracellular vesicle release to attenuate liver fibrosis.

    abstract:BACKGROUND & AIMS:Autophagy plays a crucial role in hepatic homeostasis and its deregulation has been associated with chronic liver disease. However, the effect of autophagy on the release of fibrogenic extracellular vesicles (EVs) by platelet-derived growth factor (PDGF)-stimulated hepatic stellate cells (HSCs) remain...

    journal_title:Journal of hepatology

    pub_type: 杂志文章


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  • Trends in liver transplantation 2011.

    abstract::This review will highlight some of the important recent trends in liver transplantation. When possible, we will compare and contrast these trends across various regions of the world, in an effort to improve global consensus and better recognition of emerging data. ...

    journal_title:Journal of hepatology

    pub_type: 杂志文章,评审


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    journal_title:Journal of hepatology

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  • In situ hybridization studies of hepatitis A viral RNA in patients with acute hepatitis A.

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    journal_title:Journal of hepatology

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    authors: Yuan H,Shyy JY,Martins-Green M

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    abstract:BACKGROUND & AIMS:The prognosis of patients with chronic liver disease is to a great extent determined by the presence and degree of portal hypertension (PHT). Hepatic venous pressure gradient (HVPG) has been shown to be an accurate prognostic index in patients with cirrhosis. Transient elastography is a non-invasive p...

    journal_title:Journal of hepatology

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    journal_title:Journal of hepatology

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    journal_title:Journal of hepatology

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    journal_title:Journal of hepatology

    pub_type: 杂志文章


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  • Thrombocytopenia post liver transplantation. Correlations with pre-operative platelet count, blood transfusion requirements, allograft function and outcome.

    abstract::This study reports that thrombocytopenia is a universal phenomenon post hepatic transplantation. In 53 consecutive adult patients undergoing liver transplantation the platelet count fell by a mean of 63% (157 x 10(9)/l to 50 x 10(9)/l). The platelet count reached a nadir at Day 5 post-transplant but returned to pre-op...

    journal_title:Journal of hepatology

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    abstract::This volume explores these and other issues of relevance to our understanding of the HBV life cycle and clinical management of chronic HBV infections. The ultimate goals of these studies is not just to obtain a more precise understanding of the HBV life cycle, but to also acquire an understanding that will lead to mor...

    journal_title:Journal of hepatology

    pub_type: 社论


    authors: Seeger C,Mason WS

    更新日期:2016-04-01 00:00:00

  • Human liver infiltrating γδ T cells are composed of clonally expanded circulating and tissue-resident populations.

    abstract:BACKGROUND & AIMS:γδ T cells comprise a substantial proportion of tissue-associated lymphocytes. However, our current understanding of human γδ T cells is primarily based on peripheral blood subsets, while the immunobiology of tissue-associated subsets remains largely unclear. Therefore, we aimed to elucidate the T cel...

    journal_title:Journal of hepatology

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    更新日期:2018-09-01 00:00:00

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    abstract::Fifty-eight gallbladder stones were treated in vitro, using a Wolf Piezolith 2300 lithotripter, to discover whether complete fragmentation (i.e., no particles greater than 2 mm diameter) could be achieved by lithotripsy alone. In 16 stones this was accomplished with up to 6000 shocks being administered. The degree of ...

    journal_title:Journal of hepatology

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    abstract::Recently reports have indicated that both cimetidine and ranitidine delay cell proliferation in rats following 70% partial hepatectomy and result in an increased mortality following this procedure. The present study was designed to determine whether three H2 blocking agents (cimetidine, ranitidine, famotidine) and a n...

    journal_title:Journal of hepatology

    pub_type: 杂志文章


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    journal_title:Journal of hepatology

    pub_type: 杂志文章


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  • A genome-wide association study of HCV-induced liver cirrhosis in the Japanese population identifies novel susceptibility loci at the MHC region.

    abstract:BACKGROUND & AIMS:We performed a genome-wide association study (GWAS) of hepatitis C virus (HCV)-induced liver cirrhosis (LC) to identify predictive biomarkers for the risk of LC in patients with chronic hepatitis C (CHC). METHODS:A total of 682 HCV-induced LC cases and 1045 CHC patients of Japanese origin were genoty...

    journal_title:Journal of hepatology

    pub_type: 杂志文章


    authors: Urabe Y,Ochi H,Kato N,Kumar V,Takahashi A,Muroyama R,Hosono N,Otsuka M,Tateishi R,Lo PH,Tanikawa C,Omata M,Koike K,Miki D,Abe H,Kamatani N,Toyota J,Kumada H,Kubo M,Chayama K,Nakamura Y,Matsuda K

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    journal_title:Journal of hepatology

    pub_type: 杂志文章


    authors: Ueno M,Hayami S,Shigekawa Y,Kawai M,Hirono S,Okada K,Tamai H,Shingaki N,Mori Y,Ichinose M,Yamaue H

    更新日期:2015-12-01 00:00:00

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    abstract:BACKGROUND/AIMS:The efficacy and safety of rifaximin in comparison with lactitol in the treatment of acute hepatic encephalopathy was assessed in a prospective randomized, double-blind, double-dummy, controlled trial. METHODS:A total of 103 patients with grade I-III acute hepatic encephalopathy were randomized to rece...

    journal_title:Journal of hepatology

    pub_type: 临床试验,杂志文章,随机对照试验


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    更新日期:2003-01-01 00:00:00

  • PREDICT identifies precipitating events associated with the clinical course of acutely decompensated cirrhosis.

    abstract:INTRODUCTION:Acute decompensation (AD) of cirrhosis may present without acute-on-chronic liver failure (ACLF) (AD-No ACLF), or with ACLF phenotype (AD-ACLF) defined by organ failure(s). Precipitants may induce AD. This multicenter, prospective, observational PREDICT study (NCT03056612) analyzes and characterizes the pr...

    journal_title:Journal of hepatology

    pub_type: 杂志文章


    authors: Trebicka J,Fernandez J,Papp M,Caraceni P,Laleman W,Gambino C,Giovo I,Uschner FE,Jansen C,Jimenez C,Mookerjee R,Gustot T,Albillos A,Bañares R,Jarcuska P,Steib C,Reiberger T,Acevedo J,Gatti P,Shawcross DL,Zeuzem S,

    更新日期:2020-11-20 00:00:00

  • Controlled HIV viral replication, not liver disease severity associated with low bone mineral density in HIV/HCV co-infection.

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    journal_title:Journal of hepatology

    pub_type: 杂志文章


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    更新日期:2011-10-01 00:00:00

  • Association of downregulation of cyclin D1 and of overexpression of cyclin E with p53 mutation, high tumor grade and poor prognosis in hepatocellular carcinoma.

    abstract:BACKGROUND/AIMS:The major regulatory events leading to cell proliferation occur in the G1 phase of cell cycle, and the deranged expression of G1 cyclins is related to oncogenesis. In this study, we analyzed the aberrant expressions of cyclins D1 and E, and their role in hepatocellular carcinoma. METHODS:We examined pa...

    journal_title:Journal of hepatology

    pub_type: 杂志文章


    authors: Peng SY,Chou SP,Hsu HC

    更新日期:1998-08-01 00:00:00

  • Protein expression of CD44 (standard and variant isoforms) in hepatocellular carcinoma: relationships with tumor grade, clinicopathologic parameters, p53 expression, and patient survival.

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    journal_title:Journal of hepatology

    pub_type: 杂志文章


    authors: Endo K,Terada T

    更新日期:2000-01-01 00:00:00

  • An outbreak of hepatitis A virus infection with a high case-fatality rate among injecting drug users.

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    journal_title:Journal of hepatology

    pub_type: 杂志文章


    authors: Spada E,Genovese D,Tosti ME,Mariano A,Cuccuini M,Proietti L,Giuli CD,Lavagna A,Crapa GE,Morace G,Taffon S,Mele A,Rezza G,Rapicetta M

    更新日期:2005-12-01 00:00:00