Impact of a Liver Immune Status Index among Living Liver Transplant Recipients with Hepatocellular Carcinoma

• Published in: JMA Journal 2024/04/15, Vol.7(2), pp.232-239
• Main Authors: Imaoka, Yuki, Ohira, Masahiro, Sato, Saki, Chogahara, Ichiya, Bekki, Tomoaki, Imaoka, Kouki, Nakano, Ryosuke, Yano, Takuya, Sakai, Hiroshi, Kuroda, Shintaro, Tahara, Hiroyuki, Ide, Kentaro, Kobayashi, Tsuyoshi, Tanaka, Yuka, Akabane, Miho, Sasaki, Kazunari, Ohdan, Hideki
• Format: Article
• Language: English
• Subjects: hepatocellular carcinoma (HCC); living-donor liver transplantation; natural killer (NK) cells; Original
• ISSN: 2433-328X; 2433-3298
• DOI: 10.31662/jmaj.2023-0195

Introduction: Hepatocellular carcinoma (HCC) is a major global health challenge, being the fifth most prevalent neoplasm and the third leading cause of cancer-related deaths worldwide. Liver transplantation offers a potentially curative approach for HCC, yet the risk of recurrence posttransplantation remains a significant concern. This study investigates the influence of a liver immune status index (LISI) on the prognosis of patients undergoing living-donor liver transplantation for HCC.Methods: In a single-center study spanning from 2001 to 2020, 113 patients undergoing living-donor liver transplantation for HCC were analyzed. LISI was calculated for each donor liver using body mass index, serum albumin levels, and the fibrosis-4 index. This study assessed the impact of donor LISI on short-term recurrence rates and survival, with special attention to its correlation with the antitumor activity of natural killer (NK) cells in the liver.Results: The patients were divided into two grades (high donor LISI, >−1.23 [n = 43]; and low donor LISI, ≤−1.23 [n = 70]). After propensity matching to adjust the background of recipient factors, the survival rates at 1 and 3 years were 92.6% and 88.9% and 81.5% and 70.4% in the low and high donor LISI groups, respectively (p = 0.11). The 1- and 3-year recurrence-free survival were 88.9% and 85.2% and 74.1% and 55.1% in the low and high donor LISI groups, respectively (p = 0.02).Conclusions: This study underscores the potential of an LISI as a noninvasive biomarker for assessing liver NK cell antitumor capacity, with implications for living-donor liver transplantation for HCC. Donor LISI emerges as a significant predictor of early recurrence risk following living-donor liver transplantation for HCC, highlighting the role of the liver antitumor activity of liver NK cells in managing liver malignancies.