Ischemia-reperfusion injury and the risk of hepatocellular carcinoma recurrence after deceased donor liver transplantation

Abstract This study aimed to evaluate the effects of ischemia-reperfusion injury (IRI) on the risk of hepatocellular carcinoma (HCC) recurrence after liver transplantation. Data of 195 patients were retrospectively analysed. Post-reperfusion aspartate (AST), alanine transaminase, and lactate dehydro...

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Autores principales:	Michał Grąt, Marek Krawczyk, Karolina M. Wronka, Jan Stypułkowski, Zbigniew Lewandowski, Michał Wasilewicz, Piotr Krawczyk, Karolina Grąt, Waldemar Patkowski, Krzysztof Zieniewicz
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2018
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/05b49ee1dc85475893d66de88d21dc23
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spelling	oai:doaj.org-article:05b49ee1dc85475893d66de88d21dc232021-12-02T15:08:24ZIschemia-reperfusion injury and the risk of hepatocellular carcinoma recurrence after deceased donor liver transplantation10.1038/s41598-018-27319-y2045-2322https://doaj.org/article/05b49ee1dc85475893d66de88d21dc232018-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-018-27319-yhttps://doaj.org/toc/2045-2322Abstract This study aimed to evaluate the effects of ischemia-reperfusion injury (IRI) on the risk of hepatocellular carcinoma (HCC) recurrence after liver transplantation. Data of 195 patients were retrospectively analysed. Post-reperfusion aspartate (AST), alanine transaminase, and lactate dehydrogenase (LDH) levels were the primary measures of IRI. Tumour recurrence was the primary endpoint. Post-reperfusion AST was a continuous risk factor for tumour recurrence in patients within Milan criteria (p = 0.035), with an optimal cut-off of 1896 U/L. Recurrence-free survival of patients within Milan criteria and post-reperfusion AST of <1896 and ≥1896 U/L was 96.6% and 71.9% at 5 and 3.7 years, respectively (p = 0.006). Additionally, post-reperfusion AST and LDH exceeding the upper quartile significantly increased the risk of HCC recurrence in patients within Milan criteria (p = 0.039, hazard ratio [HR] = 5.99 and p = 0.040, HR = 6.08, respectively) and to a lesser extent, in patients within Up-to-7 criteria (p = 0.028, HR = 3.58 and p = 0.039, HR = 3.33, respectively). No other significant IRI effects were found in patients beyond the Up-to-7 criteria and in analyses stratified for independent risk factors for recurrence: tumour number and differentiation, alpha-fetoprotein, and microvascular invasion. Thus, IRI exerts major negative effects on the risk of HCC recurrence after liver transplantation in patients within standard and extended criteria.Michał GrątMarek KrawczykKarolina M. WronkaJan StypułkowskiZbigniew LewandowskiMichał WasilewiczPiotr KrawczykKarolina GrątWaldemar PatkowskiKrzysztof ZieniewiczNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 8, Iss 1, Pp 1-13 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Michał Grąt Marek Krawczyk Karolina M. Wronka Jan Stypułkowski Zbigniew Lewandowski Michał Wasilewicz Piotr Krawczyk Karolina Grąt Waldemar Patkowski Krzysztof Zieniewicz Ischemia-reperfusion injury and the risk of hepatocellular carcinoma recurrence after deceased donor liver transplantation
description	Abstract This study aimed to evaluate the effects of ischemia-reperfusion injury (IRI) on the risk of hepatocellular carcinoma (HCC) recurrence after liver transplantation. Data of 195 patients were retrospectively analysed. Post-reperfusion aspartate (AST), alanine transaminase, and lactate dehydrogenase (LDH) levels were the primary measures of IRI. Tumour recurrence was the primary endpoint. Post-reperfusion AST was a continuous risk factor for tumour recurrence in patients within Milan criteria (p = 0.035), with an optimal cut-off of 1896 U/L. Recurrence-free survival of patients within Milan criteria and post-reperfusion AST of <1896 and ≥1896 U/L was 96.6% and 71.9% at 5 and 3.7 years, respectively (p = 0.006). Additionally, post-reperfusion AST and LDH exceeding the upper quartile significantly increased the risk of HCC recurrence in patients within Milan criteria (p = 0.039, hazard ratio [HR] = 5.99 and p = 0.040, HR = 6.08, respectively) and to a lesser extent, in patients within Up-to-7 criteria (p = 0.028, HR = 3.58 and p = 0.039, HR = 3.33, respectively). No other significant IRI effects were found in patients beyond the Up-to-7 criteria and in analyses stratified for independent risk factors for recurrence: tumour number and differentiation, alpha-fetoprotein, and microvascular invasion. Thus, IRI exerts major negative effects on the risk of HCC recurrence after liver transplantation in patients within standard and extended criteria.
format	article
author	Michał Grąt Marek Krawczyk Karolina M. Wronka Jan Stypułkowski Zbigniew Lewandowski Michał Wasilewicz Piotr Krawczyk Karolina Grąt Waldemar Patkowski Krzysztof Zieniewicz
author_facet	Michał Grąt Marek Krawczyk Karolina M. Wronka Jan Stypułkowski Zbigniew Lewandowski Michał Wasilewicz Piotr Krawczyk Karolina Grąt Waldemar Patkowski Krzysztof Zieniewicz
author_sort	Michał Grąt
title	Ischemia-reperfusion injury and the risk of hepatocellular carcinoma recurrence after deceased donor liver transplantation
title_short	Ischemia-reperfusion injury and the risk of hepatocellular carcinoma recurrence after deceased donor liver transplantation
title_full	Ischemia-reperfusion injury and the risk of hepatocellular carcinoma recurrence after deceased donor liver transplantation
title_fullStr	Ischemia-reperfusion injury and the risk of hepatocellular carcinoma recurrence after deceased donor liver transplantation
title_full_unstemmed	Ischemia-reperfusion injury and the risk of hepatocellular carcinoma recurrence after deceased donor liver transplantation
title_sort	ischemia-reperfusion injury and the risk of hepatocellular carcinoma recurrence after deceased donor liver transplantation
publisher	Nature Portfolio
publishDate	2018
url	https://doaj.org/article/05b49ee1dc85475893d66de88d21dc23
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Ischemia-reperfusion injury and the risk of hepatocellular carcinoma recurrence after deceased donor liver transplantation

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