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3. Liver transplantation for hepatocellular carcinoma following checkpoint inhibitor therapy with nivolumab

Author

Schnickel, Gabriel T, Fabbri, Kassandra, Hosseini, Mojgan, Misel, Michael, Berumen, Jennifer, Parekh, Justin, Mekeel, Kristin, Dehghan, Yalda, Kono, Yuko, and Ajmera, Veeral

Subjects
Clinical Trials and Supportive Activities, Liver Disease, Organ Transplantation, Transplantation, Clinical Research, Rare Diseases, Digestive Diseases, 6.1 Pharmaceuticals, Evaluation of treatments and therapeutic interventions, Good Health and Well Being, Aged, Carcinoma, Hepatocellular, Humans, Liver Neoplasms, Liver Transplantation, Middle Aged, Necrosis, Nivolumab, Retrospective Studies, cancer, malignancy, neoplasia, adjuvant therapy, clinical decision-making, clinical research, practice, complication, medical, metabolic, liver allograft function, dysfunction, liver transplantation, hepatology, cancer/malignancy/neoplasia, cancer/malignancy/neoplasia: adjuvant therapy, clinical research/practice, complication: medical/metabolic, liver allograft function/dysfunction, liver transplantation/hepatology, Medical and Health Sciences, Surgery
Abstract

Limited case series describe conflicting results regarding the safety of checkpoint inhibitors (CPI) prior to liver transplantation (LT). We reviewed single-center data on all consecutive patients who underwent LT for hepatocellular carcinoma treated with CPI between January 1, 2018, and January 30, 2021. Time from CPI to LT, immunosuppression, biopsy-proven acute cellular rejection (BPACR), graft loss and death were evaluated. Five patients with a mean age 65 (range 61-71) years underwent LT after CPI with nivolumab. Time from last CPI to LT ranged from 0.3 to 11 months. Two patients with 3 months from the last dose of CPI had BPACR. In conclusion, pretransplant use of CPIs, particularly within 90 days of LT, was associated with BPACR and immune-mediated hepatic necrosis. Future multicenter studies should consider a sufficient interval from the last dose of CPI to LT to mitigate the risk for adverse immune-mediated outcomes and graft loss.

Published
2022

4. Rescue liver re-transplantation after graft loss due to severe rejection in the setting of pre-transplant nivolumab therapy

Author

Dehghan, Yalda, Schnickel, Gabriel T, Hosseini, Mojgan, Burgoyne, Adam M, Ajmera, Veeral H, Morris, Gerald P, Mendler, Michel H, Parekh, Justin R, Abushamat, Farid, Vodkin, Irine, and Kono, Yuko

Subjects
Rare Diseases, Organ Transplantation, Transplantation, Digestive Diseases, Liver Cancer, Infectious Diseases, Liver Disease, Chronic Liver Disease and Cirrhosis, Cancer, Development of treatments and therapeutic interventions, Evaluation of treatments and therapeutic interventions, 5.2 Cellular and gene therapies, 6.4 Surgery, Good Health and Well Being, Carcinoma, Hepatocellular, Graft Rejection, Humans, Liver Neoplasms, Nivolumab, Liver transplantation, Acute rejection, Malignancy, Immune regulation, Hepatology
Abstract

Immune checkpoint inhibitors (ICI) have been used to treat hepatocellular carcinoma (HCC) since 2017. The safety of ICIs in the setting of solid organ transplantation remains controversial. When used in the post-transplant setting, ICIs have been associated with high allograft rejection rates, but there are few published reports on the use of ICIs prior to transplant. We present the first reported case of rescue liver re-transplantation after loss of the first allograft due to severe acute rejection with extensive hepatic necrosis in the setting of pre-transplant ICI therapy with the PD-1 inhibitor nivolumab. It is likely that the durable immune response triggered by nivolumab contributes to graft rejection, therefore extreme caution should be taken when using ICIs before transplant until further investigation has been conducted on their safety in the pre-transplant setting.

Published
2021

6. Posttransplant Outcomes in Older Patients With Hepatocellular Carcinoma Are Driven by Non–Hepatocellular Carcinoma Factors

Author

Adeniji, Nia, Arjunan, Vinodhini, Prabhakar, Vijay, Mannalithara, Ajitha, Ghaziani, Tara, Ahmed, Aijaz, Kwo, Paul, Nguyen, Mindie, Melcher, Marc L, Busuttil, Ronald W, Florman, Sander S, Haydel, Brandy, Ruiz, Richard M, Klintmalm, Goran B, Lee, David D, Taner, C Burcin, Hoteit, Maarouf A, Verna, Elizabeth C, Halazun, Karim J, Tevar, Amit D, Humar, Abhinav, Chapman, William C, Vachharajani, Neeta, Aucejo, Federico, Nydam, Trevor L, Markmann, James F, Mobley, Constance, Ghobrial, Mark, Langnas, Alan N, Carney, Carol A, Berumen, Jennifer, Schnickel, Gabriel T, Sudan, Debra L, Hong, Johnny C, Rana, Abbas, Jones, Christopher M, Fishbein, Thomas M, Agopian, Vatche, and Dhanasekaran, Renumathy

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Oncology and Carcinogenesis, Digestive Diseases, Clinical Research, Liver Disease, Organ Transplantation, Transplantation, Rare Diseases, Cancer, Liver Cancer, Aging, 6.1 Pharmaceuticals, Evaluation of treatments and therapeutic interventions, Good Health and Well Being, Aged, Carcinoma, Hepatocellular, Humans, Liver Neoplasms, Liver Transplantation, Middle Aged, Retrospective Studies, Risk Assessment, Survival Rate, United States, Surgery, Clinical sciences
Abstract

The incidence of hepatocellular carcinoma (HCC) is growing in the United States, especially among the elderly. Older patients are increasingly receiving transplants as a result of HCC, but the impact of advancing age on long-term posttransplant outcomes is not clear. To study this, we used data from the US Multicenter HCC Transplant Consortium of 4980 patients. We divided the patients into 4 groups by age at transplantation: 18 to 64 years (n = 4001), 65 to 69 years (n = 683), 70 to 74 years (n = 252), and ≥75 years (n = 44). There were no differences in HCC tumor stage, type of bridging locoregional therapy, or explant residual tumor between the groups. Older age was confirmed to be an independent and significant predictor of overall survival even after adjusting for demographic, etiologic, and cancer-related factors on multivariable analysis. A dose-response effect of age on survival was observed, with every 5-year increase in age older than 50 years resulting in an absolute increase of 8.3% in the mortality rate. Competing risk analysis revealed that older patients experienced higher rates of non-HCC-related mortality (P = 0.004), and not HCC-related death (P = 0.24). To delineate the precise cause of death, we further analyzed a single-center cohort of patients who received a transplant as a result of HCC (n = 302). Patients older than 65 years had a higher incidence of de novo cancer (18.1% versus 7.6%; P = 0.006) after transplantation and higher overall cancer-related mortality (14.3% versus 6.6%; P = 0.03). Even carefully selected elderly patients with HCC have significantly worse posttransplant survival rates, which are mostly driven by non-HCC-related causes. Minimizing immunosuppression and closer surveillance for de novo cancers can potentially improve the outcomes in elderly patients who received a transplant as a result of HCC.

Published
2021

7. Understanding the Impact of Pneumonia and Other Complications in Elderly Liver Transplant Recipients: An Analysis of NSQIP Transplant.

Author

Schnickel, Gabriel T, Greenstein, Stuart, Berumen, Jennifer A, Elias, Nahel, Sudan, Debra L, Conzen, Kendra D, Mekeel, Kristin L, Foley, David P, Hirose, Ryutaro, and Parekh, Justin R

Abstract

Despite an increasing demand for liver transplantation in older patients, our understanding of posttransplant outcomes in older recipients is limited to basic recipient and graft survival. Using National Surgical Quality Improvement Program Transplant, we tracked early outcomes after liver transplantation for patients >65.MethodsWe conducted a retrospective analysis of patients in National Surgical Quality Improvement Program Transplant between March 1, 2017 and March 31, 2019. Recipients were followed for 1 y after transplant with follow-up at 30, 90, and 365 d. Data were prospectively gathered using standard definitions across all sites.ResultsOne thousand seven hundred thirty-one adult liver transplants were enrolled; 387 (22.4%) were >65 y old. The majority of older recipients were transplanted for hepatocellular carcinoma. The older cohort had a lower lab Model for End-Stage Liver Disease and was less likely to be hospitalized at time of transplant. Overall, older recipients had higher rates of pneumonia but no difference in intensive care unit length of stay (LOS), total LOS, surgical site infection, or 30-d readmission. Subgroup analysis of patients with poor functional status revealed a significant difference in intensive care unit and total LOS. Pneumonia was even more common in older patients and had a significant impact on overall survival.ConclusionsBy targeting patients with hepatocellular carcinoma and lower Model for End-Stage Liver Diseases, transplant centers can achieve nearly equivalent outcomes in older recipients. However, older recipients with poor functional status require greater resources and are more likely to develop pneumonia. Pneumonia was strongly associated with posttransplant survival and represents an opportunity for improvement. By truly understanding the outcomes of elderly and frail recipients, transplant centers can improve outcomes for these higher-risk recipients.

Published
2021

9. Synchronous metastatic colon cancer and the importance of primary tumor laterality - A National Cancer Database analysis of right- versus left-sided colon cancer.

Author

Zhao, Beiqun, Lopez, Nicole E, Eisenstein, Samuel, Schnickel, Gabriel T, Sicklick, Jason K, Ramamoorthy, Sonia L, and Clary, Bryan M

Subjects
Humans, Colonic Neoplasms, Neoplasm Metastasis, Retrospective Studies, Databases, Factual, Aged, Middle Aged, Female, Male, Colon cancer, Laterality, Metastatic, NCDB, Outcomes, Cancer, Digestive Diseases, Colo-Rectal Cancer, Clinical Sciences, Surgery
Abstract

BackgroundThe role of laterality for patients with synchronous metastatic colon cancer (SMCC) is not well-defined.MethodsUsing the National Cancer Database (2010-2015), we compared patients with metastatic right- (RCC) versus left-sided colon cancer (LCC). We performed Kaplan-Meier analysis to compare overall survival (OS) for each metastatic site and utilized adjusted Cox proportional hazard analysis to identify predictors of OS.ResultsPatients with RCCs were more likely to be older, female, and have more comorbidities. LCCs were more likely to metastasize to liver and lung, whereas RCCs were more likely to metastasize to peritoneum and brain. There was equal likelihood to metastasize to bone. OS was significantly longer for LCCs for all metastatic sites. After controlling for multiple variables, RCC (HR 1.426, p

Published
2020

10. Early patient and liver allograft outcomes from donation after circulatory death donors using thoracoabdominal normothermic regional: a multi-center observational experience

Author

Brubaker, Aleah L., primary, Taj, Raeda, additional, Jackson, Brandon, additional, Lee, Arielle, additional, Tsai, Catherine, additional, Berumen, Jennifer, additional, Parekh, Justin R., additional, Mekeel, Kristin L., additional, Gupta, Alexander R., additional, Gardner, James M., additional, Chaly, Thomas, additional, Mathur, Amit K., additional, Jadlowiec, Caroline, additional, Reddy, Sudhakar, additional, Nunez, Rafael, additional, Bellingham, Janet, additional, Thomas, Elizabeth M., additional, Wellen, Jason R., additional, Pan, Jenny H., additional, Kearns, Mark, additional, Pretorius, Victor, additional, and Schnickel, Gabriel T., additional

Published
2023
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11. US Liver Transplant Outcomes After Normothermic Regional Perfusion vs Standard Super Rapid Recovery

Author

Brubaker, Aleah L., Sellers, Marty T., Abt, Peter L., Croome, Kristopher P., Merani, Shaheed, Wall, Anji, Abreu, Phillipe, Alebrahim, Musab, Baskin, Roy, Bohorquez, Humberto, Cannon, Robert M., Cederquist, Kelly, Edwards, John, Huerter, Benjamin G., Hobeika, Mark J., Kautzman, Lori, Langnas, Alan N., Lee, David D., Manzi, Joao, Nassar, Ahmed, Neidlinger, Nikole, Nydam, Trevor L., Schnickel, Gabriel T., Siddiqui, Farjad, Suah, Ashley, Taj, Raeda, Taner, C. Burcin, Testa, Giuliano, Vianna, Rodrigo, Vyas, Frederick, and Montenovo, Martin I.

Abstract

IMPORTANCE: Normothermic regional perfusion (NRP) is an emerging recovery modality for transplantable allografts from controlled donation after circulatory death (cDCD) donors. In the US, only 11.4% of liver recipients who are transplanted from a deceased donor receive a cDCD liver. NRP has the potential to safely expand the US donor pool with improved transplant outcomes as compared with standard super rapid recovery (SRR). OBJECTIVE: To assess outcomes of US liver transplants using controlled donation after circulatory death livers recovered with normothermic regional perfusion vs standard super rapid recovery. DESIGN, SETTING, AND PARTICIPANTS: This was a retrospective, observational cohort study comparing liver transplant outcomes from cDCD donors recovered by NRP vs SRR. Outcomes of cDCD liver transplant from January 2017 to May 2023 were collated from 17 US transplant centers and included livers recovered by SRR and NRP (thoracoabdominal NRP [TA-NRP] and abdominal NRP [A-NRP]). Seven transplant centers used NRP, allowing for liver allografts to be transplanted at 17 centers; 10 centers imported livers recovered via NRP from other centers. EXPOSURES: cDCD livers were recovered by either NRP or SRR. MAIN OUTCOMES AND MEASURES: The primary outcome was ischemic cholangiopathy (IC). Secondary end points included primary nonfunction (PNF), early allograft dysfunction (EAD), biliary anastomotic strictures, posttransplant length of stay (LOS), and patient and graft survival. RESULTS: A total of 242 cDCD livers were included in this study: 136 recovered by SRR and 106 recovered by NRP (TA-NRP, 79 and A-NRP, 27). Median (IQR) NRP and SRR donor age was 30.5 (22-44) years and 36 (27-49) years, respectively. Median (IQR) posttransplant LOS was significantly shorter in the NRP cohort (7 [5-11] days vs 10 [7-16] days; P < .001). PNF occurred only in the SRR allografts group (n = 2). EAD was more common in the SRR cohort (123 of 136 [56.1%] vs 77 of 106 [36.4%]; P = .007). Biliary anastomotic strictures were increased 2.8-fold in SRR recipients (7 of 105 [6.7%] vs 30 of 134 [22.4%]; P = .001). Only SRR recipients had IC (0 vs 12 of 133 [9.0%]; P = .002); IC-free survival by Kaplan-Meier was significantly improved in NRP recipients. Patient and graft survival were comparable between cohorts. CONCLUSION AND RELEVANCE: There was comparable patient and graft survival in liver transplant recipients of cDCD donors recovered by NRP vs SRR, with reduced rates of IC, biliary complications, and EAD in NRP recipients. The feasibility of A-NRP and TA-NRP implementation across multiple US transplant centers supports increasing adoption of NRP to improve organ use, access to transplant, and risk of wait-list mortality.

Published
2024
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13. Development and validation of a REcurrent Liver cAncer Prediction ScorE (RELAPSE) following liver transplantation in patients with hepatocellular carcinoma: analysis of the us multicenter hcc transplant consortium

Author

Tran, Benjamin V., primary, Moris, Dimitrios, additional, Markovic, Daniela, additional, Zaribafzadeh, Hamed, additional, Henao, Ricardo, additional, Lai, Quirino, additional, Florman, Sander S., additional, Tabrizian, Parissa, additional, Haydel, Brandy, additional, Ruiz, Richard M., additional, Klintmalm, Goran B., additional, Lee, David D., additional, Taner, C. Burcin, additional, Hoteit, Maarouf, additional, Levine, Matthew H., additional, Cillo, Umberto, additional, Vitale, Alessandro, additional, Verna, Elizabeth C., additional, Halazun, Karim J., additional, Tevar, Amit D., additional, Humar, Abhinav, additional, Chapman, William C., additional, Vachharajani, Neeta, additional, Aucejo, Federico, additional, Lerut, Jan, additional, Ciccarelli, Olga, additional, Nguyen, Mindie H., additional, Melcher, Marc L., additional, Viveiros, Andre, additional, Schaefer, Benedikt, additional, Hoppe-Lotichius, Maria, additional, Mittler, Jens, additional, Nydam, Trevor L., additional, Markmann, James F., additional, Rossi, Massimo, additional, Mobley, Constance, additional, Ghobrial, Mark, additional, Langnas, Alan N., additional, Carney, Carol A., additional, Berumen, Jennifer, additional, Schnickel, Gabriel T., additional, Sudan, Debra L., additional, Hong, Johnny C., additional, Rana, Abbas, additional, Jones, Christopher M., additional, Fishbein, Thomas M., additional, Busuttil, Ronald W., additional, Barbas, Andrew S., additional, and Agopian, Vatche G., additional

Published
2023
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14. Heart-liver-kidney transplantation for AL amyloidosis using normothermic recovery and storage from a donor following circulatory death: Short-term outcome in a first-in-world experience

Author

Brubaker, Aleah L., primary, Urey, Marcus A., additional, Taj, Raeda, additional, Parekh, Justin R., additional, Berumen, Jennifer, additional, Kearns, Mark, additional, Shah, Mita, additional, Khan, Adnan, additional, Kono, Yuko, additional, Ajmera, Veeral, additional, Barman, Pranab, additional, Tran, Hao, additional, Adler, Eric D., additional, Silva Enciso, Jorge, additional, Asimakopoulos, Fotis, additional, Costello, Caitlin, additional, Bower, Richard, additional, Sanchez, Ramon, additional, Pretorius, Victor, additional, and Schnickel, Gabriel T., additional

Published
2023
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26. Contributors

Author

Abou-Alfa, Ghassan K., Abou-Khalil, Jad, Acher, Alexandra W., Adam, Rene, Addeo, Pietro, Agarwal, Anil Kumar, Aghayan, Davit L., Ahmed, Ola, Aizpuru, Matthew J., Allard, Marc-Antoine, Allen, Peter J., Aloia, Thomas A., Alvarez, Fernando A., Amini, Neda, Andersen, Jesper B., Anderson, Christopher D., Anteby, Roi, Arslan-Carlon, Vittoria, Aussilhou, Beatrice, Awad, Joseph, Babicky, Michele L., Bachellier, Philippe, Balachandran, Vinod P., Balogun, Fiyinfolu, Barbas, Andrew S., Barkun, Jeffrey Stewart, Bassi, Claudio, Basturk, Olca, Bayona Molano, Maria del Pilar, Beard, Rachel E., Belghiti, Jacques, Bennett, Sean A., Bernal, William, Bilchik, Anton J., Boas, Franz Edward, Bonds, Morgan, Bredbeck, Brooke C., Brody, Lynn, Brown, Karen T., Bruix, Jordi, Brunt, Elizabeth M., Büchler, Markus, Callery, Mark P., Camacho, Juan C., Campbell, Andre, Carpenter, Danielle H., Carter, C. Ross, Chan, Chung Yip, Chan, See Ching, Chandwani, Rohit, Chapman, William C., Sr., Chen, Harvey S., Cherqui, Daniel, Cheung, TT, Heng Chiow, Adrian Kah, Cho, Clifford S., Chun, Yun Shin, Clary, Bryan M., Cloyd, Jordan M., Coats, Maria V., Cohen, Joshua T., Conlon, Kevin Christopher, Connell, Louise C., Corvera, Carlos Uriel, Covey, Anne M., Crane, Christopher H., Creasy, John M., Crippin, Jeffrey S., Crispe, Nick, D’Angelica, Michael I., Da Fonseca, Leonardo Gomes, Dabbous, Hany, Danford, Christopher, Darcy, Michael, Davenport, Mark, David, Yakira, Day, Ryan William, Jonge, Jeroen de, Santibanes, Eduardo de, Santibañes, Martin de, Wilde, Roeland F. de, Delpero, Jean Robert, DeMatteo, Ronald P., DePeralta, Danielle K., Desai, Niraj M., Dickinson, Shannan M., Dickson, Euan J., DiMaio, Christopher John, Gian Do, Richard Kinh, Dokmak, Safi, Doyle, Majella, Drebin, Jeffrey A., Driedger, Michael R., Dudeja, Vikas, Dunphy, Mark, Earl, Truman M., Ebata, Tomoki, Ecker, Brett Logan, Edwin, Bjorn, Ejaz, Aslam, Dika, Imane El, Endo, Itaru, Enestvedt, C. Kristian, Fagley, R. Eliot, Fan, Sheung Tat, Farges, Olivier, Farrell, Michael Steven, Ferguson, Benjamin David, Ferrer-Fàbrega, Joana, Ferrone, Cristina R., Fields, Ryan, Fischer, Mary, Fong, Yuman, Francis-West, Philippa, Fretland, Åsmund Avdem, Fridell, Jonathan A., Friedman, Scott L., Galka, Eva, Geller, David A., Gerst, Scott R., Gerstle, Justin Theodore, Gholami, Sepideh, Gilroy, Richard, Goh, Brian K.P., Gores, Gregory J., Goss, John A., Greene, Brittany Dalia, Koerkamp, Bas Groot, Hackert, Thilo, Harrington, Kate Anne, Harrison, Ewen M., Hasegawa, Kiyoshi, Hauser, Haley, Heimbach, Julie K., Hemming, Alan W., Hernandez, Jonathan, Homma, Yuki, Iacobuzio-Donahue, Christine A., Imam, Rami, Imventarza, Oscar Cesar, Sr., Iyer, Matthew Kalahasty, Jarnagin, William R., Jayaraman, Shiva, Jepperson, Maria, Ju, Michelle R., Judge, Sean J., Kahlert, Christoph, Kambakamba, Patryk, Kangrga, Ivan, Kappadath, S. Cheenu, Karanicolas, Paul J., Katz, Seth S., Kawaguchi, Yoshikuni, Kelly, Kaitlyn J., Kemeny, Nancy E., Khan, Adeel, Khan, Tahsin M., Kim, Heung Bae, Kim, Woon Cho, Kingham, T. Peter, Kingsbery, Joseph, Kirk, Allan D., Kirks, Russell C., Jr., Klimstra, David, Knechtle, Stuart, Koea, Jonathan B., Kokudo, Norihiro, Korenblat, Kevin M., Kornblith, Lucy Zumwinkle, Krampitz, Geoffrey Wayne, Krebs, Simone, Kumamoto, Takafumi, Kwon, Choon Hyuck David, Lafaro, Kelly J., Lang, Hauke, LaQuaglia, Michael J., LaQuaglia, Michael P., LaRusso, Nicholas F., Lee, Rachel M., Lee, Ser Yee, Lencioni, Riccardo, Lendoire, Javier C., Levin, Galina, Li, Kewei, Lidsky, Michael E., Lindemann, Jessica, Linehan, David, Lopez-Solis, Roberto Carlos, Lorimer, Patrick Daniel, Ma, Ka Wing, Maithel, Shishir K., Malleo, Giuseppe, Marchegiani, Giovanni, Markmann, James F., Marsh, J. Wallis, Martin, Robert CG, II, Massani, Marco, Matsuyama, Ryusei, Maxwell, Aaron W.P., Mazza, Oscar M., McGilvray, Ian D., McIntyre, Caitlin A., McKinley, Sophia K., Melendez, Jose, Melloul, Emmanuel, Mendelsohn, Robin B., Mizuno, Takashi, Moore, Hunter Burroughs, Mosconi, Cristina, Nagaraju, Santosh, Nagino, Masato, Nagorney, David M., Nagula, Satish, Nair, Amit, Nasser-Ghodsi, Navine, Naz, Nadia, Neoptolemos, John P., Neuberger, James, Nevarez, Nicole M., Newhook, Timothy E., Noda, Takehiro, Nyberg, Scott L., O’Dwyer, Elisabeth, O’Rourke, Colm J., Odisio, Bruno C., okamura, Ryosuke, Oldhafer, Karl Jürgen, Olthoff, Kim M., Olumba, Franklin, Orloff, Susan, Orr, Christine E., O’Reilly, Eileen M., Padmanabhan, Chandrasekhar, Paniccia, Alessandro, Pappas, Theodore N., Paradis, Valérie, Parks, Rowan W., Pawlik, Timothy M., Pierce-Raglione, Cassandra D., Pillarisetty, Venu G., Pingpank, James Francis, Jr., Pitt, Henry A., Polanco, Patricio M., Pomposelli, James J., Powelson, John A., Premnath, Naveen, Qadan, Motaz, Raj, Nitya, Reddy, Srinevas, Reidy-Lagunes, Diane, Reyngold, Marsha, Rice, Teresa C., Rickert, Robert W., Roberts, John Paul, Robson, Piera Marie Cote, Rocha, Flavio G., Roll, Garrett R., Rolston, Vineet Syan, Ronot, Maxime, Rosemurgy, Alexander S., II, Rosen, Charles B., Salloum, Chady, Salvia, Roberto, Samant, Hrishikesh, Sasaki, Kazunari, Schattner, Mark A., Schnickel, Gabriel T., Schulick, Richard D., Seaton, Max E., Seo, Yongwoo David, Shah, Jigesh A., Shah, Kevin N., She, Wong Hoi, Shindoh, Junichi, Shwaartz, Chaya, Sicklick, Jason K., Siegelbaum, Robert H., Smith, Martin Derrick, Soares, Kevin C., Sofocleous, Constantinos T., Solomon, Stephen B., Srinivasa, Sanket, Starlinger, Patrick, Stecca, Tommaso, Steinharter, John A., Stewart, Camille, Stewart, Lygia, Stoll, Janis, Sucandy, Iswanto, Suhocki, Paul V., Tabibian, James H., Takemura, Nobuyuki, Tang, Laura H., Thiels, Cornelius A., Timucin, Taner, Tohme, Samer, Torzilli, Guido, Cao, Hop S. Tran, Tsang, Simon Hing Yin, Turcotte, Simon, Gulik, Thomas van, Vannucci, Andrea, Vauthey, Jean-Nicolas, Wands, Jack R., Wattacheril, Julia, Weber, Sharon Marie, Wei, Alice C., Weiss, Matthew, Weitz, Jürgen, Wisneski, Andrew David, Wolfgang, Christopher L., Yang, Dennis, Yarmohammadi, Hooman, Yeo, Charles J., Yeo, Theresa Pluth, Yopp, Adam, Zeh, Herbert, Zhou, Fangyu, Zibari, Gazi B., and Zogopoulos, George

Published
2023
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32. Sa1307 Incidence, Outcome and Factors Affecting Post Liver Transplant Cholestatic Hepatitis C

Author

Zalawadia, Ashish, primary, Nagai, Shunji, additional, Salami, Augustine, additional, Parekh, Ravish, additional, Kuchipudi, Aishwarya, additional, Tabbal, Mahmoud, additional, Nakamura, Mio, additional, Altshuler, David, additional, Peterson, Ed, additional, Raoufi, Mohammad, additional, Abouljoud, Marwan, additional, Schnickel, Gabriel T., additional, Brown, Kimberly A., additional, Moonka, Dilip K., additional, and Jafri, Syed-Mohammed, additional

Published
2014
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38. Contributors

Author

Abu-Elmagd, Kareem, Ahn, Chul-Soo, Allamezadeh, Reza, M. Alonso, Estella, Alonso, Maria H., Ascher, Nancy L., Bäckman, Lars, Baker, Talia B., Balistreri, William F., Bañares, Rafael, Baquerizo, Angeles, Bathla, Lokesh, Bennet, William, Berenguer, Marina, Berlakovich, Gabriela A., Bezerra, Jorge A., Bilhartz, Jacob L., Brown, Robert S., Jr, Burroughs, Andrew, Burroughs, Sherilyn Gordon, Busuttil, Ronald W., Caicedo, Juan Carlos, Cameron, Andrew M., Campsen, Jeffrey, Carey, Elizabeth J., Carmody, Ian C., Cecka, J. Michael, Chan, See-Ching, Charlton, Michael, Cheaito, Ali, Chen, Pauline W., Chinnakotla, Srinath, Ciria, Ruben, Clavien, Pierre-Alain, Coito, Ana J., Collins, Thomas, Crippin, Jeffrey S., Cronin, David C., II, Danovitch, Gabriel M., Davis, Gary L., Gloria de la Rosa, Demetris, Anthony J., DiNorcia, Joseph, Duffy, John P., Durazo, Francisco A., Eghtesad, Bijan, Emond, Jean C., Esquivel, Carlos O., Fan, Sheung Tat, Farmer, Douglas G., Fondevila, Constantino, Forsythe, John L.R., Fox, Alyson N., Fox, Ira J., Frader, Joel E., Fredericks, Emily M., Fulmer, James M., Fung, John J., Gallegos-Orozco, Juan F., García-Valdecasas, Juan Carlos, Gerling, Till, Ghobrial, R. Mark, Gomes, Antoinette S., Gonzalez, Stevan A., Gordon, Elisa J., Green, Michael D., Harrison, Rick, Hasse, Jeanette M., Heaton, Nigel D., Hessheimer, Amelia J., Hiatt, Jonathan R., Holt, Curtis D., Hong, Johnny C., Humar, Abhinav, Ibrahim, Samar H., Ikegami, Toru, Imam, Mohamad H., Inomata, Yukihiro, Jensen, Sally E., Jowsey, Sheila, Kaldas, Fady M., Kam, Igal, Kelly, Jr., Burnett “Beau” S., Khungar, Vandana, Khwaja, Khalid, King, Kevin, Kinkhabwala, Milan, Kirk, Allan D., Kittleson, Michelle M., Klintmalm, Göran B.G., Kunder, Gregory D., Kupiec-Weglinski, Jerzy W., Lake, John R., Langnas, Alan, Lassman, Charles R., Lee, Sung-Gyu, Lin, Henry C., Lo, Chung-Mau, Lobritto, Steven, Locke, Jayme E., Lucey, Michael R., MacConmara, Malcolm, Maehara, Yoshihiko, Mai, Martin L., Makuuchi, Masatoshi, Manley, Kathy, Marder, Victor J., Markmann, James F., Martinez, Mercedes, Matesanz, Rafael, McCoy, Tara, McDiarmid, Suzanne V., McKenna, Greg J., Michaels, Marian G., Minervini, Marta I., Mobley, Constance, Moon, Deok-Bog, Moreno, Elisa A., Mühlbacher, Ferdinand, Muiesan, Paolo, Murase, Noriko, Naini, Bita V., Nalesnik, Michael A., Nathan, Jaimie D., Neuhaus, Peter, Nieto, Jose M., Nwadei, Ifeoma, O’Grady, John, O’Leary, Jacqueline G., Olthoff, Kim M., Onaca, Nicholas, Parekh, Justin, Parke, Chong, Pascher, Andreas, Persijn, Guido G., Petrowsky, Henrik, Pham, Phuong-Chi T., Pham, Phuong-Thu T., Platt, Jeffrey L., Pomfret, Elizabeth A., Porrett, Paige M., Raja Rajalingam, Rakela, Jorge, Raman, Steven S., Ramsay, Michael A.E., Randhawa, Parmjeet, Redfield, Robert R., III, Reed, Alan, Reed, Elaine F., Reich, David J., Renz, John F., Restrepo, Lucas, Roberts, John P., Roche, Bruno, Rockenschaub, Susanne Rasoul, Ross, Lainie Friedman, Ruiz, Richard, Ryckman, Frederick C., Saab, Sammy, Sai, Victor, Saliba, Faouzi, Sampaio, Luiz C., Samuel, Didier, Sano, Keiji, Sasatomi, Eizaburo, Sassi, Kareem, Saunders, Milda R., Schnickel, Gabriel T., Seetharam, Anil, Setoyama, Kentaro, Shaik, Imtiazuddin, Shaked, Abraham, Shirabe, Ken, Singal, Ashwani K., Soejima, Yuji, Starzl, Thomas E., Steadman, Randolph H., Stewart, Zoe, Stone, Marvin J., Strouse, Thomas B., Sturdevant, Mark L., Sugawara, Yasuhiko, Superina, Riccardo A., Taketomi, Akinobu, Talwalkar, Jayant A., Tanaka, Koichi, Tap, William D., Taylor, Doris A., Tiao, Greg, Tong, Myron J., Trotter, James F., Uchiyama, Hideaki, Vagefi, Parsia, Vargas, Hugo E., Venick, Robert S., Vilca-Melendez, Hector, Vincenti, Flavio, Wadei, Hani M., Washburn, Kenneth, Whitington, Peter F., Winston, Drew J., Wojciechowski, David, Wong, Deborah J.L., Yeh, Heidi, Yersiz, Hasan, Yoshizumi, Tomoharu, Zarrinpar, Ali, Zhai, Yuan, Zhang, Qiuheng, and Zimmerman, Michael A.

Published
2015
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45. Outcomes in liver transplant recipients with nonalcoholic fatty liver disease-related HCC: results from the US multicenter HCC transplant consortium.

Author

Verna EC, Phipps MM, Halazun KJ, Markovic D, Florman SS, Haydel BM, Ruiz R, Klintmalm G, Lee DD, Taner B, Hoteit MA, Tevar AD, Humar A, Chapman WC, Vachharajani N, Aucejo FN, Melcher ML, Nguyen MH, Nydam TL, Markmann JF, Mobley C, Ghobrial RM, Langnas AN, Carney C, Berumen J, Schnickel GT, Sudan D, Hong JC, Rana A, Jones CM, Fishbein TM, Busuttil RW, and Agopian V

Subjects
Adult, Humans, Retrospective Studies, Neoplasm Recurrence, Local pathology, Risk Factors, Carcinoma, Hepatocellular epidemiology, Carcinoma, Hepatocellular surgery, Carcinoma, Hepatocellular pathology, Liver Neoplasms epidemiology, Liver Neoplasms surgery, Liver Neoplasms pathology, Non-alcoholic Fatty Liver Disease complications, Non-alcoholic Fatty Liver Disease epidemiology, Non-alcoholic Fatty Liver Disease surgery, Liver Transplantation adverse effects
Abstract

NAFLD will soon be the most common indication for liver transplantation (LT). In NAFLD, HCC may occur at earlier stages of fibrosis and present with more advanced tumor stage, raising concern for aggressive disease. Thus, adult LT recipients with HCC from 20 US centers transplanted between 2002 and 2013 were analyzed to determine whether NAFLD impacts recurrence-free post-LT survival. Five hundred and thirty-eight (10.8%) of 4981 total patients had NAFLD. Patients with NAFLD were significantly older (63 vs. 58, p<0.001), had higher body mass index (30.5 vs. 27.4, p<0.001), and were more likely to have diabetes (57.3% vs. 28.8%, p<0.001). Patients with NAFLD were less likely to receive pre-LT locoregional therapy (63.6% vs. 72.9%, p<0.001), had higher median lab MELD (15 vs. 13, p<0.001) and neutrophil-lymphocyte ratio (3.8 vs. 2.9, p<0.001), and were more likely to have their maximum pre-LT alpha fetoprotein at time of LT (44.1% vs. 36.1%, p<0.001). NAFLD patients were more likely to have an incidental HCC on explant (19.4% vs. 10.4%, p<0.001); however, explant characteristics including tumor differentiation and vascular invasion were not different between groups. Comparing NAFLD and non-NAFLD patients, the 1, 3, and 5-year cumulative incidence of recurrence (3.1%, 9.1%, 11.5% vs. 4.9%, 10.1%, 12.6%, p=0.36) and recurrence-free survival rates (87%, 76%, and 67% vs. 87%, 75%, and 67%, p=0.97) were not different. In competing risks analysis, NAFLD did not significantly impact recurrence in univariable (HR: 0.88, p=0.36) nor in adjusted analysis (HR: 0.91, p=0.49). With NAFLD among the most common causes of HCC and poised to become the leading indication for LT, a better understanding of disease-specific models to predict recurrence is needed. In this NAFLD cohort, incidental HCCs were common, raising concerns about early detection. However, despite less locoregional therapy and high neutrophil-lymphocyte ratio, explant tumor characteristics and post-transplant recurrence-free survival were not different compared to non-NAFLD patients., (Copyright © 2022 American Association for the Study of Liver Diseases.)

Published
2023
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