title: Clinical outcomes of liver transplantation for HBV-related hepatocellular carcinoma: data from the NIH HBV OLT study.
abstract: BACKGROUND
  Hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) is an indication for orthotopic liver transplantation (OLT) in patients with tumor stage within the United Network for Organ Sharing criteria. The number of patients listed for HBV-related HCC is increasing, while the number of patients listed for HBV-related cirrhosis is declining presumptively because of the availability of more effective oral nucleos(t)ide analogues. This study presents the final, long-term outcome of patients transplanted for HBV-related HCC in the National Institutes of Health (NIH) HBV OLT Study Group.
  
  
  RESULTS
  Ninety-eight patients (52.4%) in the NIH HBV OLT cohort underwent OLT for HBV-related HCC. With a mean follow-up of 36.5 months post-OLT, 12 (12.2%) patients developed recurrence of HCC. Multivariate analysis did not find a statistically significant role of gender, tumor stage at OLT, pre-OLT HCC treatment, recurrence of HBV, or duration of HCC diagnosis pre-OLT in predicting HCC recurrence. Serum alpha-fetoprotein (AFP) level >200 ng/mL at transplant was found to be statistically significant in predicting HCC recurrence (p=0.003). HCC recurrence was significantly associated with decreased post-OLT survival.
  
  
  CONCLUSIONS
  HCC is the most common indication for OLT in patients with chronic hepatitis B in the era of more effective oral antivirals. Serum AFP at the time of OLT is significantly associated with HCC recurrence.
authors.affiliation: David Geffen School of Medicine at UCLA, Los Angeles, CA, USA. steven.han@ucla.edu
authors.forename: Steven-Huy
authors.initials: SH
authors.lastname: Han
authors.forename: K Rajender
authors.initials: KR
authors.lastname: Reddy
authors.forename: Emmet B
authors.initials: EB
authors.lastname: Keeffe
authors.forename: Consuelo
authors.initials: C
authors.lastname: Soldevila-Pico
authors.forename: Robert
authors.initials: R
authors.lastname: Gish
authors.forename: Raymond T
authors.initials: RT
authors.lastname: Chung
authors.forename: Bulent
authors.initials: B
authors.lastname: Degertekin
authors.forename: Anna
authors.initials: A
authors.lastname: Lok
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000601:surgery* / Q000821:virology; D004279:DNA, Viral / Q000235:genetics; D005260:Female; D006509:Hepatitis B / Q000150:complications / Q000601:surgery*; D006515:Hepatitis B virus / Q000235:genetics; D006801:Humans; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000601:surgery* / Q000821:virology; D016031:Liver Transplantation / Q000009:adverse effects / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D015996:Survival Rate; D016896:Treatment Outcome; D000509:alpha-Fetoproteins / Q000378:metabolism
chemical_list: D004279:DNA, Viral; D000509:alpha-Fetoproteins