Donor characteristics and risk of hepatocellular carcinoma recurrence after liver transplantation

Abstract

Results: A total of 9724 liver transplant recipients were included. Patients receiving a graft procured from a donor older than 60 years (adjusted hazard ratio (HR) 1⋅38, 95 per cent c.i. 1⋅10 to 1⋅73; P = 0⋅006), a donor with a history of diabetes (adjusted HR 1⋅43, 1⋅11 to 1⋅83; P = 0⋅006) and a donor with a body mass index of 35 kg/m 2 or more (adjusted HR 1⋅36, 1⋅04 to 1⋅77; P = 0⋅023) had an increased rate of post-transplant HCC recurrence. In 3007 patients with documented steatosis, severe graft steatosis (more than 60 per cent) was also linked to an increased risk of recurrence (adjusted HR 1⋅65, 1⋅03 to 2⋅64; P = 0⋅037). Recipients of organs from donation after cardiac death donors with prolonged warm ischaemia had higher recurrence rates (adjusted HR 4⋅26, 1⋅20 to 15⋅1; P = 0⋅025).Conclusion: Donor-related factors such as donor age, body mass index, diabetes and steatosis are associated with an increased rate of HCC recurrence after liver transplantation.

Tolerogenic properties of liver macrophages in non‐alcoholic steatohepatitis

“…After 12 weeks of feeding on a choline‐deficient diet, mouse livers were enlarged and showed yellowish discoloration, consistent with our previous observations that choline‐deficient diet elicits steatohepatitis . We isolated liver macrophages from mouse livers with or without diet‐induced steatohepatitis, by in vivo liver perfusion, non‐parenchymal cell isolation and magnetic cell sorting.…”

“…This diet contains 15% of caloric content as crude fat and is supplemented in methionine. Choline‐deficient diet was given for 12 weeks in order to induce significant hepatocellular lipid accumulation and hepatic inflammatory changes, based on our previous study . Control animals received standard chow for the same duration.…”

Intention‐to‐treat analysis of liver transplantation for hepatocellular carcinoma: The impact of pre‐existing diabetes mellitus

“…Operative mortality was defined as death occurring either in the perioperative period during hospitalization for LT or up to 90 days post‐LT. The secondary endpoint was HCC recurrence after LT. Hepatocellular carcinoma recurrence was defined according to the study reported by Samoylova et al, and the detailed procedure can refer to the study reported by Toso et al…”

“…Many studies have confirmed that the use of tumour morphology and biology in selection criteria could predict the risk of post‐transplant HCC recurrence . Recently, Orci et al reported that donor characteristics and liver graft quality were associated with an increased rate of HCC recurrence after LT …”

Donation after cardiac death in the hepatocellular carcinoma patient: Same indication?

“…There is concern, however, that the increased ischemia/reperfusion injury associated with DCD donor livers may be protumorogenic. Some studies have demonstrated that hepatic ischemia/reperfusion injury can exacerbate liver tumor growth and metastasis by activation of cell adhesion, invasion, and angiogenesis pathways which could negatively impact patients with HCC receiving a DCD OLT . There has been no confirmatory clinical data that HCC recurrence in recipients of OLT has been influenced by graft type, however .…”