title: Recurrent hepatocellular carcinoma in liver transplant recipients with hepatitis C.
abstract: OBJECTIVE
  Hepatitis C (HCV) is the most common liver disease in patients transplanted with hepatocellular carcinoma (HCC) in the West. We examined predictors of HCC recurrence in liver transplant recipients with HCV.
  
  
  METHODS
  From 1997 to 2006, 53 patients with HCC and HCV underwent liver transplantation. Pre-and post-operative data (including liver biopsies 4 months post-transplant) were collected. Differences between HCC recurrence and non-recurrence groups were detected by Student's t test or chi-square test. Data were analyzed as predictors of HCC recurrence by logistic regression multivariate analysis. Cumulative survival was analyzed by Kaplan-Meier curves and compared by the log-rank test.
  
  
  RESULTS
  Eleven of 53 patients (20.8%) developed HCC recurrence at a median interval of 15 months (2 to 55 months). Median Histology Activity Index (HAI) of liver biopsies, AST, and ALT at 4 months were significantly greater in patients with HCC recurrence. Independent predictors of HCC recurrence were HAI ≥ 4 at 4 months, ALT ≥ 100 at 4 months, and vascular invasion. Patients with HCC recurrence had significantly decreased survival.
  
  
  CONCLUSIONS
  In this preliminary study, Histology Activity Index and ALT at 4 months, as well as vascular invasion, predicted HCC recurrence in liver transplant recipients with HCV.
authors.affiliation: Division of Transplantation in the Department of Surgery, University of Florida College of Medicine, Jacksonville, FL, USA.
authors.forename: Ivan
authors.initials: I
authors.lastname: Zendejas-Ruiz
authors.forename: Alan W
authors.initials: AW
authors.lastname: Hemming
authors.forename: Chaoru
authors.initials: C
authors.lastname: Chen
authors.forename: Jason J
authors.initials: JJ
authors.lastname: Schwartz
authors.forename: John B
authors.initials: JB
authors.lastname: Sorensen
authors.forename: Robin D
authors.initials: RD
authors.lastname: Kim
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000453:epidemiology* / Q000473:pathology / Q000821:virology; D005260:Female; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000821:virology; D016031:Liver Transplantation / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology* / Q000473:pathology