Turkish Journal of Gastroenterology
Liver - Original Article

Hepatitis B and hepatocellular carcinoma recurrence after living donor liver transplantation: The role of the Milan criteria

1.

Department of Gastroenterology, İzmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, TurkeyDepartment of Gastroenterology, İzmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey

2.

Department of Liver Transplantation, Kent Hospital, İzmir, Turkey

3.

Department of Gastroenterology, Tepecik Training and Research Hospital, İzmir, Turkey

Turk J Gastroenterol 2019; 30: 75-80
DOI: 10.5152/tjg.2018.18794
Read: 630 Downloads: 112 Published: 25 July 2019

Abstract

Background/Aims: The aim of this study was to evaluate the effect of the Milan criteria on the hepatitis B virus (HBV) and hepatocellular carcinoma (HCC) recurrence in patients who underwent living donor liver transplantation due to HBV-induced cirrhosis and HCC.

 

Materials and Methods: We evaluated a total of 142 patients, 88 who underwent transplantation due to HBV-induced cirrhosis and 54 due to HCC, between 2009 and 2014. In the posttranplant period, after the HBsAg seroconversion, 400 IU of hepatitis B immunoglobulin were applied intramuscularly every 2 weeks, and daily nucleos(t)ide analogs were continued as prophylaxis. The HBV recurrence was defined as the presence of HBsAg in serum. Patients were screened for alpha-fetoprotein levels and imaging for evaluation of HCC recurrence.

 

Results: The average follow-up period was 26 (2-65) months. Fifty-four patients had HCC. The HCC recurrence was observed in 12 patients during the follow-up period. The HBV recurrence was observed in four patients. Three of the patients who developed HBV recurrence had liver transplantation due to HCC. Tumor recurrence was observed 1.4-12 months following the HBV recurrence. The HCC recurrence within the Milan criteria and beyond the Milan criteria was 0% vs. 28.4 % in the first year and 3.4% vs. 47.5% in the third year. The cumulative incidence of the HBV recurrence was 2.8% and 3.7% for the first year and 3.7% for the third year. The HBV recurrence was more frequently detected in patients with HCC (p=0.048), especially with HCC beyond the Milan criteria (p=0.044).

 

Conclusion: The HBV recurrence should be evaluated as a predictor of the HCC recurrence in patients who underwent liver transplantation due to HCC with exceeding Milan criteria.

 

Cite this article as: Vatansever S, Farajov R, Yılmaz HC, Zeytunlu M, Paköz ZB, Kılıç M. Hepatitis B and hepatocellular carcinoma recurrence after living donor liver transplantation: The role of the Milan Criteria. Turk J Gastroenterol 2019; 30: 75-80.

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