Gül-Klein, Safak; Kästner, Anika; Haber, Philipp Konstantin; Krenzien, Felix; Wabitsch, Simon; Krannich, Alexander; Andreou, Andreas; Eurich, Dennis; Tacke, Frank; Horst, David; Pratschke, Johann; Schmelzle, Moritz (2021). Recurrence of Hepatocellular Carcinoma After Liver Transplantation is Associated with Episodes of Acute Rejections. Journal of hepatocellular carcinoma, 8, pp. 133-143. Dove Press 10.2147/JHC.S292010
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Purpose
The impact of acute rejection (AR) after liver transplantation (LT) for hepatocellular carcinoma (HCC) on patient outcome is uncertain. This aim of this study is to investigate whether AR is associated with HCC relapse and overall survival.
Patients and Methods
Patients undergoing LT for HCC between 2001 and 2015 were retrospectively analyzed with regard to histopathological proven AR within the median time until recurrence. Cox's regression analysis was conducted revealing risk factors for HCC recurrence.
Results
HCC recurred in 47 of 252 analyzed patients with a median time to recurrence of 20 months. Patients with AR (28.6%) had a significantly higher frequency of recurrence compared to patients without AR (13.0%, p=0.002). Multiple Cox regression analyses identified AR within 20 months to be an independent risk factor for HCC recurrence both as dichotomized (HR=2.91, 95%CI: 1.30-6.53; p=0.009) and as a continuous variable (HR=1.81, 95%CI: 1.28-2.54; p=0.001). HCC recurrence and AR were associated with higher grades of liver fibrosis one year after LT, when compared to patients without AR (p=0.019).
Conclusion
Our results demonstrate an association of AR with HCC recurrence after LT with implications for intervals of monitoring in tumor surveillance. Graft fibrosis and immune mechanisms are potentially related and causal interactions are worth further investigation.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine |
UniBE Contributor: |
Andreou, Andreas |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
2253-5969 |
Publisher: |
Dove Press |
Language: |
English |
Submitter: |
Rahel Fuhrer |
Date Deposited: |
26 Oct 2021 16:56 |
Last Modified: |
05 Dec 2022 15:53 |
Publisher DOI: |
10.2147/JHC.S292010 |
PubMed ID: |
33777855 |
Uncontrolled Keywords: |
graft fibrosis histology immunological mechanisms predictors of tumor relapse protocol liver biopsy |
BORIS DOI: |
10.48350/160151 |
URI: |
https://boris.unibe.ch/id/eprint/160151 |
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