0000000000344014
AUTHOR
Konrad Lehner
Hepatocellular carcinoma recurrence after acute liver allograft rejection treatment: A multicenter European experience
During the last decades, several risk factors for the recurrence of hepatocellular carcinoma (HCC) after liver transplantation (LT) have been investigated. However, the impact of two important drivers of oncogenesis, namely the immunosuppression and the treatment of acute cellular rejection (ACR) have been marginally addressed. This study aimed at investigating the impact of ACR treatment on the incidence of tumor recurrence in a large European HCC-LT population. Seven hundred and eighty-one adult patients transplanted between February 1, 1985 and June 30, 2016 were retrospectively analyzed. After propensity score match, 116 patients treated for ACR using steroid boluses were compared with …
An Intention-to-Treat Competing-Risk Model for Candidates with Hepatocellular Cancer Awaiting Liver Transplantation
Background: Since the introduction of the Milan Criteria (MC), all systems, which describe post-transplant prognosis of patients with hepatocellular cancer (HCC), are exclusively based on characteristics available at surgery, and neglect the intention-to-treat principles. This study, based on a large international HCC patient cohort, aimed to develop comprehensive intention-to-treat models through a competing-risk analysis. We used data available at first referral to predict the risk of delisting and HCC-related death after liver transplantation (LT). Methods: Twelve centres in the United States, Europe and Asia created a Derivation Set (n=2,318) and an external Validation Set (n=773) of …