Abstract
Aim: To analyze the relationship between hepatitis B virus (HBV) and hepatocellular carcinoma (HCC) recurrence in orthotopic liver transplantation (OLT) patients. Methods: 340 HBV patients with OLT were included in the study; among them were 148 patients with HBV-associated HCC. Results: HCC recurrence rates at 1, 3 and 5 years were 21, 29, and 46%, respectively. Exceeding Milan criteria (hazard ratio, HR = 12.35; 95% confidence interval, CI, 2.80–54.49; p = 0.001), HBV DNA level >5 log10 copies/ml before transplant (HR = 2.45; 95% CI 1.10–5.45; p = 0.03) and HBV recurrence (HR = 2.27; 95% CI 1.10–4.75; p = 0.03) were significant independent predictors of HCC recurrence. HBV DNA >5 log10 copies/ml before transplant (HR = 8.65; 95% CI 3.40–21.98; p < 0.001) and concomitance with HCC (HR = 2.79; 95% CI 1.33–5.87; p = 0.007) were predictors of HBV recurrence. Further stratified analysis showed that HBV recurrence was more prevalent in the HCC recurrence group (HR = 4.58; 95% CI 1.88–11.12; p = 0.001). Conclusions: There is a close relationship between HBV and HCC recurrence after transplant. High HBV DNA levels before transplant are associated with HCC recurrence after transplant.
Journal Section:
Original Paper
References
1.
Kiyici M, Yilmaz M, Akyildiz M, Arikan C, Aydin U, Siqirli D, Nart D, Yilmaz F, Ozacar T, Karasu Z, Kilic M: Association between hepatitis B and hepatocellular carcinoma recurrence in patients undergoing liver transplantation. Transplant Proc 2008;40:1511–1517.
[PubMed]
2.
Mazzaferro V, Regalia E, Doci R, Andreola S, Pulvirenti A, Bozzetti F, Montalto F, Ammatuna M, Morabito A, Gennari L: Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med 1996;334:693–699.
[PubMed]
3.
Figueras J, Jaurrieta E, Valls C, Benasco C, Rafecas A, Xiol X, Fabregat J, Casanovas T, Torras J, Baliellas C, Ibañez L, Moreno P, Casais L: Survival after liver transplantation in cirrhotic patients with and without hepatocellular carcinoma: a comparative study. Hepatology 1997;25:1485–1489.
[PubMed]
4.
Molmenti EP, Klintmalm GB: Liver transplantation in association with hepatocellular carcinoma: an update of the International Tumor Registry. Liver Transpl 2002;8:736–748.
[PubMed]
5.
Shimoda M, Ghobrial RM, Carmody IC, Anselmo DM, Farmer DG, Yersiz H, Chen P, Dawson S, Durazo F, Han S, Goldstein LI, Saab S, Hiatt J, Busuttil RW: Predictors of survival after liver transplantation for hepatocellular carcinoma associated with hepatitis C. Liver Transpl 2004;10:1478–1486.
[PubMed]
6.
Yang HI, Lu SN, Liaw YF, You SL, Sun CA, Wang LY, Hsiao CK, Chen PJ, Chen DS, Chen CJ: Hepatitis B e antigen and the risk of hepatocellular carcinoma. N Engl J Med 2002;347:168–174.
[PubMed]
7.
Llovet JM, Bruix J: Novel advancements in the management of hepatocellular carcinoma in 2008. J Hepatol 2008;48:S20–S37.
[PubMed]
8.
Ou DP, Yang LY, Huang GW, Tao YM, Ding X, Chang ZG: Clinical analysis of the risk factors for recurrence of HCC and its relationship with HBV. World J Gastroenterol 2005;11:2061–2066.
[PubMed]
9.
Kubo S, Hirohashi K, Tanaka H, Tsukamoto T, Shuto T, Yamamoto T, Ikebe T, Wakasa K, Nishiguchi S, Kinoshita H: Effect of viral status on recurrence after liver resection for patients with hepatitis B virus-related hepatocellular carcinoma. Cancer 2000;88:1016–1024.
[PubMed]
10.
Jiao ZY, Jiao Z: Prophylaxis of recurrent hepatitis B in Chinese patients after liver transplantation using lamivudine combined with hepatitis B immune globulin according to the titer of antibody to hepatitis B surface antigen. Transplant Proc 2007;39:1533–1536.
[PubMed]
11.
Yi NJ, Suh KS, Cho JY, Kwon CH, Lee KW, Joh JW, Lee SK, Kim SI, Lee KU: Recurrence of hepatitis B is associated with cumulative corticosteroid dose and chemotherapy against hepatocellular carcinoma recurrence after liver transplantation. Liver Transpl 2007;13:451–458.
[PubMed]
12.
Jang JW, Choi JY, Bae SH, Yoon SK, Woo HY, Chang UI, Kim CW, Nam SW, Cho SH, Yang JM, Lee CD: The impact of hepatitis B viral load on recurrence after complete necrosis in patients with hepatocellular carcinoma who receive transarterial chemolipiodolization. Cancer 2007;110:1760–1767.
[PubMed]
13.
Seehofer D, Berg T: Prevention of hepatitis B recurrence after liver transplantation. Transplantation 2005;80:S120–S124.
[PubMed]
14.
Faria LC, Giqou M, Roque-Afonso A, Sebagh M, Roche B, Fallot G, Ferrari TC, Guettier C, Dussaix E, Castaing D, Brechot C, Samuel D: Hepatocellular carcinoma is associated with an increased risk of hepatitis B virus recurrence after liver transplantation. Gastroenterology 2008;134:1890–1899.
[PubMed]
15.
Schwartz M, Konstadoulakis M, Roayaie S: Recurrence of hepatocellular carcinoma after liver transplantation: is immunosuppression a factor? Liver Transpl 2005;11:494–495.
[PubMed]
16.
Chen CJ, Yang HI, Su J, Jen CL, You SL, Lu SN, Huang GT, Iloeje UH: Risk of hepatocellular carcinoma across a biological gradient of serum hepatitis B virus DNA level. JAMA 2006;295:265–273.
17.
Yuan HJ, Yuen MF, Ka-Ho Wong D, Sablon E, Lai CL: The relationship between HBV-DNA levels and cirrhosis-related complications in Chinese with chronic hepatitis B. J Viral Hepat 2005;12:373–379.
[PubMed]
18.
Ishikawa H, Nakao K, Matsumoto K, Nishimura D, Ichikawa T, Hamasaki K, Eguchi K: Bone marrow engraftment in a rodent model of chemical carcinogenesis but no role in the histogenesis of hepatocellular carcinoma. Gut 2004;53:884–889.
[PubMed]
19.
Kubota K, Soeda J, Misawa R Mihara M, Miwa S, Ise H, Takahashi M, Miyagawa S: Bone marrow-derived cells fuse with hepatic oval cells but are not involved in hepatic tumorigenesis in the choline-deficient ethionine-supplemented diet rat model. Carcinogenesis 2008;29:448–454.
[PubMed]
20.
Zheng JF, Liang LJ: Transplanted bone marrow stromal cells are not cellular origin of hepatocellular carcinomas in a mouse model of carcinogenesis. World J Gastroenterol 2008;14:3015–3020.
[PubMed]
21.
Yang ZF, Ngai P, Ho DW Yu WC, Ng MN, Lau CK, Li ML, Tam KH, Lam CT, Poon RT, Fan ST: Identification of local and circulating cancer stem cells in human liver cancer. Hepatology 2008;47:919–928.
[PubMed]
22.
Zimmerman MA, Ghobrial RM, Tong MJ, Hiatt JR, Cameron AM, Busuttil RW: Antiviral prophylaxis and recurrence of hepatocellular carcinoma following liver transplantation in patients with hepatitis B. Transplant Proc 2007;39:3276–3280.
[PubMed]
© 2011 S. Karger AG, Basel
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