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Antiviral prophylaxis and recurrence of hepatocellular carcinoma following liver transplantation in patients with hepatitis B.

Abstract：

BACKGROUND:Orthotopic liver transplantation (OLT) is a viable treatment option for patients with hepatitis B (HBV) and concomitant hepatocellular carcinoma (HCC). However, cancer recurrence following transplantation approaches 20%. This study sought to identify the clinical and pathological factors associated with post-OLT survival. METHODS:Univariate and multivariate analyses considered the following variables: combination viral prophylaxis, HBV recurrence, tumor stage, vascular invasion, distribution, nodularity, pre- and post-OLT tumor size, pre-OLT alpha-fetoprotein (AFP), Milan and UCSF criteria, and Asian race. RESULTS:Cumulatively, HCC recurrence-free survival was 77%, 62%, and 53% at 1, 3, and 5 years, respectively, and was significantly better in patients who were free of viral recurrence post-OLT. Similarly, patients treated with combination prophylaxis had a significantly lower mortality than those who were not. CONCLUSIONS:Multivariate analysis revealed that AFP>500 ng/mL, presence of vascular invasion by explant, HBV recurrence, and combination prophylaxis were independent predictors of HCC recurrence-free survival.

journal_name

Transplant Proc

journal_title

Transplantation proceedings

authors

Zimmerman MA,Ghobrial RM,Tong MJ,Hiatt JR,Cameron AM,Busuttil RW

doi

10.1016/j.transproceed.2007.07.085

subject

Has Abstract

pub_date

2007-12-01 00:00:00

pages

3276-80

issue

10

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(07)01087-1

journal_volume

39

pub_type

杂志文章

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