O-2 EVALUATION OF RISK FACTORS AND PROGNOSIS OF HEPATOCELLULAR CARCINOMA RECURRENCE AFTER LIVER TRANSPLANTATION

• Published in: Annals of hepatology 2024-02, Vol.29, p.101252, Article 101252
• Main Authors: Araujo, Alexandre, Andreola, Sophia, Cezimbra, Leonardo, Agnol, Vitoria Dal, Cheinquer, Hugo, De Conto, Jeronimo, Cabral, Roberta, Thadeu, Carlos, Rosito, Cleber, Chedid, Marcio, Álvares-Da-Silva, Mário Reis
• Format: Article
• Language: English
• ISSN: 1665-2681; 2659-5982
• DOI: 10.1016/j.aohep.2023.101252

Liver transplantation (LT) is the preferred treatment for early-stage HCC. Despite restrictive criteria (Milan), recurrence is high and negatively impacts on LT survival. This study aimed to evaluate risk factors and prognosis of HCC recurrence after LT. Retrospective Brazilian university hospital HCC-transplanted cohort (2002 -2021). Patients transplanted for other causes, with a follow-up < 1 year or with incidental HCC at explant were excluded. Primary outcome was recurrence of HCC. Secondary outcomes were survival and time elapsed until HCC diagnosis. Tumor burden was the sum diameter of all nodules at explant. Data extraction was conducted with Excel, and statistical analysis was performed with SPSS. 186 patients were included (males 123 [66.1%], median age 56 years-old), 153 (82.3%) Milan-in. Locoregional waiting-list therapy was trans arterial chemoembolization (TACE), percutaneous ethanol injection (PEI) or TACE + PEI in 63 (34.2%), 58 (31.5%) and 42 (22.8%) individuals, respectively. Downstaging was achieved in 31 patients (17.8%). Explant analysis with microvascular invasion and Milan-out was detected in 31 (16.9%) and 33 (18%) individuals, respectively. HCC recurrence occurred in 22/183 patients (12%), associated with pre-LT alfa-fetoprotein (AFP) (1.881 [IQR 109-4.510] x 6 [IQR 3-39], p=0.02), Milan-out at explant (59.1% x 11.3%, p