Potential role of the donor in hepatocellular carcinoma recurrence after liver transplantation

Parsia A. Vagefi, Jennifer L. Dodge, Francis Y. Yao, John P. Roberts

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

A subset of liver transplantation (LT) recipients who undergo transplantation for hepatocellular carcinoma (HCC) will develop postoperative recurrence. There has yet to be a thorough investigation of donor factors influencing recurrence. Data regarding adult, primary LT recipients with HCC (n = 5002) who underwent transplantation between January 1, 2006 and September 30, 2010 were extracted from the United Network for Organ Sharing database, and the cumulative incidence of post-LT recurrence by donor factors was subsequently estimated. Among the HCC LT recipients, 324 (6.5%) developed recurrence. An analysis of donor characteristics demonstrated a higher cumulative incidence of recurrence within 4 years of transplantation among recipients with donors ≤ 60 years old (11.8% versus 7.3% with donors < 60 years old, P < 0.001) and with donors from a nonlocal share distribution (10.6% versus 7.4% with donors with a local share distribution, P = 0.004). The latter 2 findings held true in a multivariate analysis: the risk of HCC recurrence increased by 70% for recipients of livers from donors ≤ 60 years old [subhazard ratio (SHR) = 1.70, 95% confidence interval (CI) = 1.31-2.20, P < 0.001] and by 42% for recipients of nonlocal share distribution livers (SHR = 1.42, 95% CI = 1.09-1.84, P = 0.009) after adjustments for clinical characteristics. In conclusion, the consideration of certain donor factors may reduce the cumulative incidence of posttransplant HCC recurrence and thus improve long-term survival after LT.

Original languageEnglish (US)
Pages (from-to)187-194
Number of pages8
JournalLiver Transplantation
Volume21
Issue number2
DOIs
StatePublished - Feb 1 2015
Externally publishedYes

Fingerprint

Liver Transplantation
Hepatocellular Carcinoma
Recurrence
Transplantation
Incidence
Confidence Intervals
Liver
Multivariate Analysis
Databases

ASJC Scopus subject areas

  • Surgery
  • Hepatology
  • Transplantation

Cite this

Potential role of the donor in hepatocellular carcinoma recurrence after liver transplantation. / Vagefi, Parsia A.; Dodge, Jennifer L.; Yao, Francis Y.; Roberts, John P.

In: Liver Transplantation, Vol. 21, No. 2, 01.02.2015, p. 187-194.

Research output: Contribution to journalArticle

Vagefi, Parsia A. ; Dodge, Jennifer L. ; Yao, Francis Y. ; Roberts, John P. / Potential role of the donor in hepatocellular carcinoma recurrence after liver transplantation. In: Liver Transplantation. 2015 ; Vol. 21, No. 2. pp. 187-194.
@article{a61442d7681445398d3461c95ea95eec,
title = "Potential role of the donor in hepatocellular carcinoma recurrence after liver transplantation",
abstract = "A subset of liver transplantation (LT) recipients who undergo transplantation for hepatocellular carcinoma (HCC) will develop postoperative recurrence. There has yet to be a thorough investigation of donor factors influencing recurrence. Data regarding adult, primary LT recipients with HCC (n = 5002) who underwent transplantation between January 1, 2006 and September 30, 2010 were extracted from the United Network for Organ Sharing database, and the cumulative incidence of post-LT recurrence by donor factors was subsequently estimated. Among the HCC LT recipients, 324 (6.5{\%}) developed recurrence. An analysis of donor characteristics demonstrated a higher cumulative incidence of recurrence within 4 years of transplantation among recipients with donors ≤ 60 years old (11.8{\%} versus 7.3{\%} with donors < 60 years old, P < 0.001) and with donors from a nonlocal share distribution (10.6{\%} versus 7.4{\%} with donors with a local share distribution, P = 0.004). The latter 2 findings held true in a multivariate analysis: the risk of HCC recurrence increased by 70{\%} for recipients of livers from donors ≤ 60 years old [subhazard ratio (SHR) = 1.70, 95{\%} confidence interval (CI) = 1.31-2.20, P < 0.001] and by 42{\%} for recipients of nonlocal share distribution livers (SHR = 1.42, 95{\%} CI = 1.09-1.84, P = 0.009) after adjustments for clinical characteristics. In conclusion, the consideration of certain donor factors may reduce the cumulative incidence of posttransplant HCC recurrence and thus improve long-term survival after LT.",
author = "Vagefi, {Parsia A.} and Dodge, {Jennifer L.} and Yao, {Francis Y.} and Roberts, {John P.}",
year = "2015",
month = "2",
day = "1",
doi = "10.1002/lt.24042",
language = "English (US)",
volume = "21",
pages = "187--194",
journal = "Liver Transplantation",
issn = "1527-6465",
publisher = "John Wiley and Sons Ltd",
number = "2",

}

TY - JOUR

T1 - Potential role of the donor in hepatocellular carcinoma recurrence after liver transplantation

AU - Vagefi, Parsia A.

AU - Dodge, Jennifer L.

AU - Yao, Francis Y.

AU - Roberts, John P.

PY - 2015/2/1

Y1 - 2015/2/1

N2 - A subset of liver transplantation (LT) recipients who undergo transplantation for hepatocellular carcinoma (HCC) will develop postoperative recurrence. There has yet to be a thorough investigation of donor factors influencing recurrence. Data regarding adult, primary LT recipients with HCC (n = 5002) who underwent transplantation between January 1, 2006 and September 30, 2010 were extracted from the United Network for Organ Sharing database, and the cumulative incidence of post-LT recurrence by donor factors was subsequently estimated. Among the HCC LT recipients, 324 (6.5%) developed recurrence. An analysis of donor characteristics demonstrated a higher cumulative incidence of recurrence within 4 years of transplantation among recipients with donors ≤ 60 years old (11.8% versus 7.3% with donors < 60 years old, P < 0.001) and with donors from a nonlocal share distribution (10.6% versus 7.4% with donors with a local share distribution, P = 0.004). The latter 2 findings held true in a multivariate analysis: the risk of HCC recurrence increased by 70% for recipients of livers from donors ≤ 60 years old [subhazard ratio (SHR) = 1.70, 95% confidence interval (CI) = 1.31-2.20, P < 0.001] and by 42% for recipients of nonlocal share distribution livers (SHR = 1.42, 95% CI = 1.09-1.84, P = 0.009) after adjustments for clinical characteristics. In conclusion, the consideration of certain donor factors may reduce the cumulative incidence of posttransplant HCC recurrence and thus improve long-term survival after LT.

AB - A subset of liver transplantation (LT) recipients who undergo transplantation for hepatocellular carcinoma (HCC) will develop postoperative recurrence. There has yet to be a thorough investigation of donor factors influencing recurrence. Data regarding adult, primary LT recipients with HCC (n = 5002) who underwent transplantation between January 1, 2006 and September 30, 2010 were extracted from the United Network for Organ Sharing database, and the cumulative incidence of post-LT recurrence by donor factors was subsequently estimated. Among the HCC LT recipients, 324 (6.5%) developed recurrence. An analysis of donor characteristics demonstrated a higher cumulative incidence of recurrence within 4 years of transplantation among recipients with donors ≤ 60 years old (11.8% versus 7.3% with donors < 60 years old, P < 0.001) and with donors from a nonlocal share distribution (10.6% versus 7.4% with donors with a local share distribution, P = 0.004). The latter 2 findings held true in a multivariate analysis: the risk of HCC recurrence increased by 70% for recipients of livers from donors ≤ 60 years old [subhazard ratio (SHR) = 1.70, 95% confidence interval (CI) = 1.31-2.20, P < 0.001] and by 42% for recipients of nonlocal share distribution livers (SHR = 1.42, 95% CI = 1.09-1.84, P = 0.009) after adjustments for clinical characteristics. In conclusion, the consideration of certain donor factors may reduce the cumulative incidence of posttransplant HCC recurrence and thus improve long-term survival after LT.

UR - http://www.scopus.com/inward/record.url?scp=84921764295&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84921764295&partnerID=8YFLogxK

U2 - 10.1002/lt.24042

DO - 10.1002/lt.24042

M3 - Article

C2 - 25371243

AN - SCOPUS:84921764295

VL - 21

SP - 187

EP - 194

JO - Liver Transplantation

JF - Liver Transplantation

SN - 1527-6465

IS - 2

ER -