Factors Increasing Recurrence of Hepatocellular Carcinoma Post Liver Transplant

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Liver transplant has been used to achieve an oncologic ‘cure’ for unresectable hepatocellular carcinoma (HCC). Despite some excellent outcomes and careful donor selection, a subset of liver-recipients experience a recurrence of HCC post-transplant. Parsia A. Vagefi and his team set out to research the cause of carcinoma recurrence and whether there are identifiable donor-derived factors.

6.5% of recipients (324 transplant recipients) experienced HCC recurrence post-transplant between 2006-2010. The data was statistically significant for an increased risk of HCC recurrence within 4 years post-transplant when the donors were aged at least 60 years (11.8% vs. 7.3%; P < .001). Another statistically significant factor for recurrence was when recipients received a liver from nonlocal share distribution (10.6% vs. 7.4%; P = .004).

Applying a multivariate analysis identified transplant recipients carrying a 70% higher risk for HCC recurrence if they received a liver from a donor aged at least 60 years and a 42% increased risk for HCC recurrence if they received a liver from nonlocal share distribution.

Utilizing these donor-derived factors in the selection process for the potential recipients, may improve long-term survival post-transplant, according to Vagefi.

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