Antiviral Prophylaxis and Recurrence of Hepatocellular Carcinoma Following Liver Transplantation in Patients With Hepatitis B

M. A. Zimmerman, R. M. Ghobrial, M. J. Tong, J. R. Hiatt, A. M. Cameron, R. W. Busuttil

Research output: Contribution to journalArticle

30 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)3276-3280
Number of pages5
JournalTransplantation Proceedings
Volume39
Issue number10
DOIs
StatePublished - Dec 2007

ASJC Scopus subject areas

  • Surgery
  • Transplantation

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