Hepatocellular Carcinoma in Renal Transplant Patients

Chronic liver diseases, especially those related to hepatitis B (HBV) and C viruses (HCV), are a common problem in renal transplant patients. Hepatocellular carcinoma (HCC) is a complication of chronic liver diseases, incidence in the renal transplant cohort is higher than in the general population...

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Bibliographic Details
Published in:Transplantation proceedings 2005-06, Vol.37 (5), p.2086-2088
Main Authors: Ridruejo, E., Mandó, O.G., Dávalos, M., Díaz, C., Vilches, A.
Format: Article
Language:English
Subjects:
Carcinoma, Hepatocellular - epidemiology
Cohort Studies
Female
Humans
Incidence
Kidney Transplantation - adverse effects
Kidney Transplantation - mortality
Liver Neoplasms - epidemiology
Liver Neoplasms - mortality
Male
Prevalence
Retrospective Studies
Survival Analysis
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Summary:Chronic liver diseases, especially those related to hepatitis B (HBV) and C viruses (HCV), are a common problem in renal transplant patients. Hepatocellular carcinoma (HCC) is a complication of chronic liver diseases, incidence in the renal transplant cohort is higher than in the general population (1.4% to 4% vs 0.005% to 0.015%). We retrospectively evaluated the incidence of HCC, its clinical presentation, the treatments, and the relation to chronic viral hepatitis among the population transplanted at our center between January 1980 and December 1998 and followed to August 2003. During the study period, six recipients among 534 renal transplants displayed HCC (incidence 1.12% of the entire population and 2.29% of patients with chronic viral hepatitis). Among the cohort five were men, and all had chronic viral hepatitis: three HBV, one HCV, and 2, a coinfection. HCC was diagnosed 124.1 (range 45 to 244) months after transplantation. All patients presented with abnormal liver function tests and tumors larger than 5 cm. Four had more than three tumors and three had an alpha-fetoprotein level higher than 400 IU/mL. Three patients received no treatment (survivals 1, 1, and 4 months); two patients, chemoembolization (survival 6 and 12 months); and one, surgical ethanol injections (survival 4 months). The overall survival was 4.5 months. HCC in renal transplant recipients is a common complication among patients with chronic viral hepatitis. The outcome was poor because HCC was detected at an advanced stage. Screening strategies for early diagnosis must be prospectively evaluated.
ISSN:0041-1345
1873-2623
DOI:10.1016/j.transproceed.2005.03.010