title: Rapid fibrosis and significant histologic recurrence of hepatitis C after liver transplant is associated with higher tumor recurrence rates in hepatocellular carcinomas associated with hepatitis C virus-related liver disease: a single center retrospective analysis.
abstract: OBJECTIVE
  Hepatitis C virus recurrence after transplant is universal. Histologic recurrence is observed in > 50% hepatitis C virus-infected grafts within the first year. The primary aim of our study was to evaluate factors responsible for hepatocellular carcinoma recurrence and mortality including histologic markers.
  
  
  METHODS
  All patients who had undergone transplant for hepatocellular carcinoma associated with hepatitis C virus from 2002 to 2012 were evaluated retrospectively.
  
  
  RESULTS
  There were 109 patients with hepatocellular carcinoma associated with hepatitis C virus that underwent living-donor liver transplant from July 2002 to June 2012. On univariate analysis, preoperative Model for End-Stage Liver Disease Score (P = .026), α-fetoprotein level (P = .020), rapid fibrosis (P = .008), and Hepatitis Activity Index ≥ 6 (P = .008) were associated with recurrence. On multivariate Cox proportional hazards regression model, Model for End-Stage Liver Disease score (P < .0001) and rapid fibrosis (P = .015) independently predicted hepatocellular carcinoma recurrence.
  
  
  CONCLUSIONS
  Hepatitis C virus recurrence on biopsy is a poor prognostic indicator and is associated with a higher risk of hepatocellular carcinoma recurrence after liver transplant. Rapid fibrosis after liver transplant independently predicts hepatocellular carcinoma recurrence.
authors: From the Hepato-Biliary and Liver Transplant, Continental Hospital, Hyderabad, India; and the Liver Surgery and Liver Transplantation, Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
authors: Bhavin B
authors: BB
authors: Vasavada
authors: Chao Long
authors: CL
authors: Chan
mesh_terms: D001706:Biopsy; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D016009:Chi-Square Distribution; D006526:Hepatitis C / Q000150:complications* / Q000175:diagnosis / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000401:mortality / Q000601:surgery* / Q000821:virology; D008113:Liver Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000601:surgery* / Q000821:virology; D016031:Liver Transplantation / Q000009:adverse effects* / Q000401:mortality; D019520:Living Donors; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D016016:Proportional Hazards Models; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013624:Taiwan; D013997:Time Factors; D016896:Treatment Outcome