RT Journal Article
T1 Mortality after Transplantation for Hepatocellular Carcinoma: A Study from the European Liver Transplant Registry.
A1 Pommergaard, Hans-Christian
A1 Rostved, Andreas Arendtsen
A1 Adam, René
A1 Rasmussen, Allan
A1 Salizzoni, Mauro
A1 Bravo, Miguel Angel Gómez
A1 Cherqui, Daniel
A1 De Simone, Paolo
A1 Houssel-Debry, Pauline
A1 Mazzaferro, Vincenzo
A1 Soubrane, Olivier
A1 García-Valdecasas, Juan Carlos
A1 Prous, Joan Fabregat
A1 Pinna, Antonio D
A1 O'Grady, John
A1 Karam, Vincent
A1 Duvoux, Christophe
A1 Thygesen, Lau Caspar
K1 Cirrhosis
K1 Hepatocellular carcinoma
K1 Liver transplantation
K1 Non-cirrhotic liver
K1 Prognosis
K1 Propensity score calibration
K1 Unmeasured confounding
AB Prognosis after liver transplantation differs between hepatocellular carcinoma (HCC) arising in cirrhotic and non-cirrhotic livers and aetiology is poorly understood. The aim was to investigate differences in mortality after liver transplantation between these patients. We included patients from the European Liver Transplant Registry transplanted due to HCC from 1990 to November 2016 and compared cirrhotic and non-cirrhotic patients using propensity score (PS) calibration of Cox regression estimates to adjust for unmeasured confounding. We included 22,787 patients, of whom 96.5% had cirrhosis. In the unadjusted analysis, non-cirrhotic patients had an increased risk of overall mortality with a hazard ratio (HR) of 1.37 (95% confidence interval [CI] 1.23-1.52). However, the HR approached unity with increasing adjustment and was 1.11 (95% CI 0.99-1.25) when adjusted for unmeasured confounding. Unadjusted, non-cirrhotic patients had an increased risk of HCC-specific mortality (HR 2.62, 95% CI 2.21-3.12). After adjustment for unmeasured confounding, the risk remained significantly increased (HR 1.62, 95% CI 1.31-2.00). Using PS calibration, we showed that HCC in non-cirrhotic liver has similar overall mortality, but higher HCC-specific mortality. This may be a result of a more aggressive cancer form in the non-cirrhotic liver as higher mortality could not be explained by tumour characteristics or other prognostic variables.
SN 2235-1795
YR 2020
FD 2020-05-12
LK http://hdl.handle.net/10668/16356
UL http://hdl.handle.net/10668/16356
LA en
DS RISalud
RD Apr 7, 2025