The influence of OKT3 therapy on hepatocellular carcinoma recurrence following liver transplantation.
BACKGROUND
Cancer recurrence following orthotopic liver transplantation (OLT) for hepatocellular carcinoma (HCC) is a significant obstacle in up to 10-20% of recipients. Recent evidence suggests that anti-CD3 antibody (OKT3) therapy may be associated with increased rates of HCC recurrence.


METHODS
At the University of Colorado Transplant Center, 173 patients underwent OLT for end-stage liver disease with concomitant HCC between 1997 and 2008. Nine clinical and pathologic variables were analyzed to test the association between OKT3 therapy for steroid-resistant rejection (SRR) and HCC recurrence-free survival.


RESULTS
Overall, the rate of HCC recurrence in this cohort was low and comparable across treatment groups (8.7%). Multivariate analysis reveals that increasing tumor diameter and differentiation have a negative impact on HCC recurrence-free survival.


CONCLUSIONS
While several pathologic variables appear to influence outcome, we found no association between OKT3 therapy for SRR and HCC recurrence or survival.
Zimmerman
Michael A
MA
Division of Transplant Surgery, University of Colorado at Denver and Health Sciences Center, Department of Anesthesia, Aurora, CO 800451, USA. michael.zimmerman@ucdenver.edu
Kelly
Mara A
MA
Campsen
Jeffrey
J
Mandell
M Susan
MS
Wachs
Michael
M
Bak
Tom
T
Skibba
Afshin
A
Lancaster
Brian
B
Kam
Igal
I
D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000628:therapy*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008113:Liver Neoplasms / Q000473:pathology / Q000628:therapy*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D016853:Muromonab-CD3 / Q000627:therapeutic use*; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D016853:Muromonab-CD3