Ischemia-reperfusion injury and the risk of hepatocellular carcinoma recurrence after deceased donor liver transplantation

This study aimed to evaluate the effects of ischemia-reperfusion injury (IRI) on the risk of hepatocellular carcinoma (HCC) recurrence after liver transplantation. Data of 195 patients were retrospectively analysed. Post-reperfusion aspartate (AST), alanine transaminase, and lactate dehydrogenase (L...

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Published in:Scientific reports 2018-06, Vol.8 (1), p.8935-13, Article 8935
Main Authors: Grąt, Michał, Krawczyk, Marek, Wronka, Karolina M., Stypułkowski, Jan, Lewandowski, Zbigniew, Wasilewicz, Michał, Krawczyk, Piotr, Grąt, Karolina, Patkowski, Waldemar, Zieniewicz, Krzysztof
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692/4020/4021/1607/1604
692/4020/4021/1607/1610/4029
692/4028/546
692/499
Alanine
Alanine transaminase
Hepatocellular carcinoma
Humanities and Social Sciences
Ischemia
L-Lactate dehydrogenase
Lactic acid
Liver cancer
Liver transplantation
Liver transplants
Microvasculature
multidisciplinary
Reperfusion
Risk factors
Science
Science (multidisciplinary)
Transaminase
Tumors
α-Fetoprotein
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creator Grąt, Michał
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Grąt, Karolina
Patkowski, Waldemar
Zieniewicz, Krzysztof
description This study aimed to evaluate the effects of ischemia-reperfusion injury (IRI) on the risk of hepatocellular carcinoma (HCC) recurrence after liver transplantation. Data of 195 patients were retrospectively analysed. Post-reperfusion aspartate (AST), alanine transaminase, and lactate dehydrogenase (LDH) levels were the primary measures of IRI. Tumour recurrence was the primary endpoint. Post-reperfusion AST was a continuous risk factor for tumour recurrence in patients within Milan criteria (p = 0.035), with an optimal cut-off of 1896 U/L. Recurrence-free survival of patients within Milan criteria and post-reperfusion AST of
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Data of 195 patients were retrospectively analysed. Post-reperfusion aspartate (AST), alanine transaminase, and lactate dehydrogenase (LDH) levels were the primary measures of IRI. Tumour recurrence was the primary endpoint. Post-reperfusion AST was a continuous risk factor for tumour recurrence in patients within Milan criteria (p = 0.035), with an optimal cut-off of 1896 U/L. Recurrence-free survival of patients within Milan criteria and post-reperfusion AST of &lt;1896 and ≥1896 U/L was 96.6% and 71.9% at 5 and 3.7 years, respectively (p = 0.006). Additionally, post-reperfusion AST and LDH exceeding the upper quartile significantly increased the risk of HCC recurrence in patients within Milan criteria (p = 0.039, hazard ratio [HR] = 5.99 and p = 0.040, HR = 6.08, respectively) and to a lesser extent, in patients within Up-to-7 criteria (p = 0.028, HR = 3.58 and p = 0.039, HR = 3.33, respectively). No other significant IRI effects were found in patients beyond the Up-to-7 criteria and in analyses stratified for independent risk factors for recurrence: tumour number and differentiation, alpha-fetoprotein, and microvascular invasion. 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Data of 195 patients were retrospectively analysed. Post-reperfusion aspartate (AST), alanine transaminase, and lactate dehydrogenase (LDH) levels were the primary measures of IRI. Tumour recurrence was the primary endpoint. Post-reperfusion AST was a continuous risk factor for tumour recurrence in patients within Milan criteria (p = 0.035), with an optimal cut-off of 1896 U/L. Recurrence-free survival of patients within Milan criteria and post-reperfusion AST of &lt;1896 and ≥1896 U/L was 96.6% and 71.9% at 5 and 3.7 years, respectively (p = 0.006). Additionally, post-reperfusion AST and LDH exceeding the upper quartile significantly increased the risk of HCC recurrence in patients within Milan criteria (p = 0.039, hazard ratio [HR] = 5.99 and p = 0.040, HR = 6.08, respectively) and to a lesser extent, in patients within Up-to-7 criteria (p = 0.028, HR = 3.58 and p = 0.039, HR = 3.33, respectively). No other significant IRI effects were found in patients beyond the Up-to-7 criteria and in analyses stratified for independent risk factors for recurrence: tumour number and differentiation, alpha-fetoprotein, and microvascular invasion. Thus, IRI exerts major negative effects on the risk of HCC recurrence after liver transplantation in patients within standard and extended criteria.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>29895820</pmid><doi>10.1038/s41598-018-27319-y</doi><tpages>13</tpages><orcidid>https://orcid.org/0000-0003-3372-3072</orcidid><oa>free_for_read</oa></addata></record>
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subjects 692/4020/4021/1607/1604
692/4020/4021/1607/1610/4029
692/4028/546
692/499
Alanine
Alanine transaminase
Hepatocellular carcinoma
Humanities and Social Sciences
Ischemia
L-Lactate dehydrogenase
Lactic acid
Liver cancer
Liver transplantation
Liver transplants
Microvasculature
multidisciplinary
Reperfusion
Risk factors
Science
Science (multidisciplinary)
Transaminase
Tumors
α-Fetoprotein
title Ischemia-reperfusion injury and the risk of hepatocellular carcinoma recurrence after deceased donor liver transplantation
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