title: Glutamate dehydrogenase and alkaline phosphatase as very early predictors of hepatocellular carcinoma recurrence after liver transplantation.
abstract: BACKGROUND
  Although long-term survival rates for patients undergoing liver transplant (LT) for hepatocellular carcinoma (HCC) are good, the relatively high rate of tumor recurrence after LT necessitates the identification of biological parameters that supplement morphological predictors of recurrence.
  
  
  METHODS
  From chart review we identified 175 patients who received liver transplantation due to HCC at our center between January 2000 and December 2013. We documented demographic and clinical data, as well as clinicopathological characteristics of the tumors, with a focus on liver values at the time of LT.
  
  
  RESULTS
  HCC recurred in 23% of LT patients. Most recurrences (59%) occurred within 12 months after LT; hardly any recurrence was detected later than 3 years after LT. Recurrence was positively correlated with tumor size, tumor stage and alpha-fetoprotein level (AFP), and it was most likely with certain causes of liver disease. Interestingly, tumor recurrence was independently predicted by serum levels of glutamate dehydrogenase (GLDH) and alkaline phosphatase (AP) at the time of LT.
  
  
  CONCLUSIONS
  Because all HCC recurrence occurs within 36 months after LT, HCC detected more than 3 years after LT may be considered de novo. Liver values, with GLDH and AP being the most preponderant, serve as easy-to-assess biomarkers which contribute to predict the risk of tumor recurrence.
authors: Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Essen, Germany.
authors: Katja
authors: K
authors: Piras-Straub
authors: Khaleda
authors: K
authors: Khairzada
authors: Guido
authors: G
authors: Gerken
authors: Fuat
authors: F
authors: Saner
authors: Jürgen
authors: J
authors: Treckmann
authors: Andreas
authors: A
authors: Paul
authors: Ali
authors: A
authors: Canbay
authors: Kerstin
authors: K
authors: Herzer
mesh_terms: D000328:Adult; D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood*; D014408:Biomarkers, Tumor / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000201:enzymology* / Q000473:pathology / Q000601:surgery; D005260:Female; D005355:Fibrosis / Q000209:etiology / Q000601:surgery; D005969:Glutamate Dehydrogenase / Q000097:blood*; D006801:Humans; D008113:Liver Neoplasms / Q000201:enzymology* / Q000473:pathology / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000201:enzymology* / Q000473:pathology; D009367:Neoplasm Staging; D011184:Postoperative Period; D012189:Retrospective Studies; D012306:Risk; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D014408:Biomarkers, Tumor; D000509:alpha-Fetoproteins; D005969:Glutamate Dehydrogenase; D000469:Alkaline Phosphatase