title: Hepatocellular carcinoma after kidney transplantation: analysis of Hong Kong Renal Registry.
abstract: Kidney transplant recipients have increased risk of cancers when compared with the general population. Hepatocellular carcinoma (HCC) is extremely important in Asia where hepatitis B virus (HBV) infection is endemic. The aim is to study the epidemiological and clinical aspects of all de novo HCC in our kidney transplant recipients. Moreover, various preventive strategies which may help to optimize the outcome will also be discussed. A retrospective review of all patients who developed HCC after kidney transplantation between May 1972 and December 2011 in Hong Kong, based on the data from Hong Kong Renal Registry. After a follow-up period of 40,246 person-years, 20 patients (males 15: females 5) developed HCC. The annual incidence was 49.7/100,000 persons per year. Among them, 16 were HBV carriers, 2 were hepatitis C (HCV) carriers and 2 had HBV and HCV co-infection. Presence of HBV infection was associated with 78-fold higher risk for HCC development. Majority (85%) were asymptomatic when HCC was diagnosed by ultrasound or alpha-fetoprotein surveillance. All patients diagnosed by surveillance received active treatment while 2/3 of symptomatic patients could only receive symptomatic care and died rapidly. In conclusion, HBV infection is the major etiological factor for HCC development in kidney transplant recipients in HBV endemic areas. Regular HCC surveillance appeared to be able to detect early stage cancers which are amenable to treatment and offer the best hope of cure.
authors.affiliation: Renal Unit, Queen Elizabeth Hospital , Hong Kong .
authors.forename: Chi Yuen
authors.initials: CY
authors.lastname: Cheung
authors.forename: Man Fai
authors.initials: MF
authors.lastname: Lam
authors.forename: Kai Ming
authors.initials: KM
authors.lastname: Chow
authors.forename: William
authors.initials: W
authors.lastname: Lee
authors.forename: Yuk Lun
authors.initials: YL
authors.lastname: Cheng
authors.forename: Sze Kit
authors.initials: SK
authors.lastname: Yuen
authors.forename: Ping Nam
authors.initials: PN
authors.lastname: Wong
authors.forename: Ka Leung
authors.initials: KL
authors.lastname: Mo
authors.forename: Kay Tai
authors.initials: KT
authors.lastname: Leung
authors.forename: Sze Ho
authors.initials: SH
authors.lastname: Wong
authors.forename: Yiu Wing
authors.initials: YW
authors.lastname: Ho
authors.forename: Ka Foon
authors.initials: KF
authors.lastname: Chau
mesh_terms: D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology*; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D016030:Kidney Transplantation; D008113:Liver Neoplasms / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012042:Registries; D012189:Retrospective Studies
keywords: Hepatocellular carcinoma; incidence; kidney transplantation