title: A novel model for evaluating the risk of hepatitis B recurrence after liver transplantation.
abstract: BACKGROUND
  Hepatitis B virus (HBV) recurrence is a major risk factor affecting the long-term survival of recipients for liver transplantation (LTx). Therefore, a model that can assess this risk before transplantation is highly desirable.
  
  
  METHODS
  One hundred and eighty-five consecutive liver transplant recipients because of HBV-related end-stage liver diseases were selected. Their perioperative laboratory examination results, treatment protocol and the status of HBV recurrence were the primary parameters used to assess their risk of post-transplant HBV recurrence. A model that may be generally used to evaluate the risk of post-transplant HBV recurrence was thus established. A cohort for further validation and a cross-validation were designed.
  
  
  RESULTS
  After a follow-up time of 26.0 ± 10.8 months, the overall HBV recurrence rate was 8.6%. The 1-, 2- and 3-year cumulative survival rates were 98.5, 89.2 and 83.4% respectively. By correlation with the pretransplant presence of hepatocelluar carcinoma (HCC), serum HBV DNA level and status of antiviral treatment (AVT), the risk assessment model can be summarized using the following equation: RISK=-4.378 + 1.493 × HCC + 1.286 × DNA - 2.426 × AVT. The HBV recurrence rate and survival were found to be significantly different between the recipients with risk scores ≤-2.8 and >-2.8. The model was well validated in this work.
  
  
  CONCLUSIONS
  Pretransplant HBV DNA level, presence of HCC, AVT status and post-transplant viral mutation were identified as the major risk factors associated with HBV recurrence after LTx. A novel model incorporating these factors could effectively evaluate the risk of post-transplant HBV recurrence before transplantation.
authors: Department of Surgery, Division of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
authors: Xiao
authors: X
authors: Xu
authors: Zhenhua
authors: Z
authors: Tu
authors: Bei
authors: B
authors: Wang
authors: Qi
authors: Q
authors: Ling
authors: Lin
authors: L
authors: Zhang
authors: Lin
authors: L
authors: Zhou
authors: Guoping
authors: G
authors: Jiang
authors: Jian
authors: J
authors: Wu
authors: Shusen
authors: S
authors: Zheng
mesh_terms: D000328:Adult; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006509:Hepatitis B / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D016019:Survival Analysis
chemical_list: D004279:DNA, Viral