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Liver transplant for hepatocellular carcinoma in the United States: Evolving trends over the last three decades.
- Source :
-
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons [Am J Transplant] 2020 Jan; Vol. 20 (1), pp. 220-230. Date of Electronic Publication: 2019 Oct 11. - Publication Year :
- 2020
-
Abstract
- Hepatitis C virus infection has been the most common etiology in HCC-related liver transplantation (LT). Since 2014, direct-acting antivirals (DAAs) have dramatically improved HCV cure. We aimed to study the changing pattern of etiologies and impact in outcome in HCC-related LT according to HCV treatment-era through retrospective analysis of the Scientific Registry of Transplant Recipients (SRTR) database (1987-2017). A total of 27 855 HCC-related liver transplants were performed (median age 59 years, 77% male). In the DAA era (2014-2017) there has been a 14.6% decrease in LT for HCV-related HCC; however, HCV remains the most common etiology in 50% of cases. In the same era, there has been a 50% increase in LT for NAFLD-related HCC. Overall survival was significantly worse for HCV-related HCC compared to NAFLD-related HCC during pre-DAA era (2002-2013; P = .031), but these differences disappeared in the DAA era. In addition, HCV patients had a significant improvement in survival when comparing the DAA era with IFN era (P < .001). Independent predictors of survival were significantly different in the pre-DAA era (HCV, AFP, diabetes) than in the DAA era (tumor size). HCV-related HCC continues to be the main indication for LT in the DAA era, but patients' survival has significantly improved and is comparable to that of NAFLD-related HCC.<br /> (© 2019 The American Society of Transplantation and the American Society of Transplant Surgeons.)
- Subjects :
- Aged
Carcinoma, Hepatocellular pathology
Carcinoma, Hepatocellular surgery
Carcinoma, Hepatocellular virology
Female
Follow-Up Studies
Hepacivirus isolation & purification
Hepatitis C virology
Humans
Liver Neoplasms pathology
Liver Neoplasms surgery
Liver Neoplasms virology
Male
Middle Aged
Prognosis
Retrospective Studies
Survival Rate
Time Factors
United States
Carcinoma, Hepatocellular mortality
Hepatitis C complications
Liver Neoplasms mortality
Liver Transplantation mortality
Registries statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1600-6143
- Volume :
- 20
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
- Publication Type :
- Academic Journal
- Accession number :
- 31437349
- Full Text :
- https://doi.org/10.1111/ajt.15576