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Cited by 16Hepatocellular Carcinoma Treatment and PrognosisOrgan Transplantation Techniques and OutcomesLiver Disease Diagnosis and Treatment

The DOI matches its Crossref record; 37 of the 37 references it cites were found in a registry or an index.

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

Verna, Elizabeth C., Phipps, Meaghan M., Halazun, Karim J., Markovic, Daniela, Florman, Sander S., Haydel, Brandy M., Ruiz, Richard, Klintmalm, Goran, Lee, David D., Taner, Burcin, Hoteit, Maarouf A., Tevar, Amit D., Humar, Abhinav, Chapman, William C., Vachharajani, Neeta, Aucejo, Federico N., Melcher, Marc L., Nguyen, Mindie H., Nydam, Trevor L., Markmann, James F., Mobley, Constance, Ghobrial, Rafik M., Langnas, Alan N., Carol Carney, Berumen, Jennifer, Schnickel, Gabriel T., Sudan, Debra, Hong, Johnny C., Rana, Abbas, Jones, Christopher M., Fishbein, Thomas M., Busuttil, Ronald W., Agopian, Vatche, The US Multicenter HCC Transplant Consortium·2023·Liver Transplantation
DOI 10.1097/lvt.0000000000000007
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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.

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Crossref · 10.1097/lvt.0000000000000007

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37 of 37 references verified0 citation errors · 0 not checkable

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  • Long-term graft and recipient survival after liver transplantation do not differ in many retrospective and registry analyses between adults with MASLD and others.

    “Despite the overall higher rate of risk factors in adults with MASLD, long-term graft and recipient survival after liver transplantation do not differ in many retrospective and registry analyses, 482,486,487 supporting that candidates with MASLD can be safely transplanted, if properly”

    From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [486]

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Metadata

Authors
Verna, E. C., Phipps, M. M., Halazun, K. J., Markovic, D., Florman, S. S., Haydel, B. M., Ruiz, R., Klintmalm, G., Lee, D. D., Taner, B., Hoteit, M. A., Tevar, A. D., Humar, A., Chapman, W. C., Vachharajani, N., Aucejo, F. N., Melcher, M. L., Nguyen, M. H., Nydam, T. L., Markmann, J. F., Mobley, C., Ghobrial, R. M., Langnas, A. N., Carney, C., Berumen, J., Schnickel, G. T., Sudan, D., Hong, J. C., Rana, A., Jones, C. M., Fishbein, T. M., Busuttil, R. W., Agopian, V., & The US Multicenter HCC Transplant Consortium
Affiliations
  • Columbia University Irving Medical Center (US)
  • Weill Cornell Medicine (US)
  • University of California, Los Angeles (US)
  • Mount Sinai Hospital (US)
  • Baylor University Medical Center (US)
  • Annette C. and Harold C. Simmons Transplant Institute, Baylor University Medical Center, Dallas, Texas, USA
  • Mayo Clinic (US)
  • Department of Transplantation, Mayo Clinic, Jacksonville, Florida, USA
  • University of Pennsylvania (US)
  • University of Pittsburgh Medical Center (US)
  • Washington University in St. Louis (US)
  • Cleveland Clinic (US)
  • Houston Methodist (US)
  • University of California San Diego (US)
  • Medical College of Wisconsin (US)
  • Baylor College of Medicine (US)
  • University of Louisville (US)
  • Georgetown University (US)
Corresponding author
Verna, Elizabeth C.
ORCID
Venue
Liver Transplantation
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2022-12-23
Volume
29
Issue
1
Pages
34-47
ISSN
1527-6465 (ISSN-L)
DOI
10.1097/lvt.0000000000000007
OpenAlex
W4315620519
Cited by
16
References
37
Citations by year
2026: 3 · 2025: 5 · 2024: 8
FWCI
1.93
Type
journal article
Language
en
Open access
closed
Locations
  • Liver Transplantation (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Hepatology › Hepatocellular Carcinoma Treatment and Prognosis
  • Health Sciences › Medicine › Surgery › Organ Transplantation Techniques and Outcomes
  • Health Sciences › Medicine › Hepatology › Liver Disease Diagnosis and Treatment
Keywords
non-alcoholic fatty liver disease, hepatocellular carcinoma, HCC recurrence, recurrence-free survival, competing risks, locoregional therapy, alpha-fetoprotein, MELD score, neutrophil-to-lymphocyte ratio, post-transplant outcomes, obesity
MeSH terms
Adult, Carcinoma, Hepatocellular, Humans, Liver Neoplasms, Neoplasm Recurrence, Local, Retrospective Studies, Risk Factors, Liver Transplantation, Non-alcoholic Fatty Liver Disease

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