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Does graft hemodynamics affect the risk of hepatocellular carcinoma recurrence after liver transplantation?
Author(s) -
Matsushima Hajime,
AcevedoMoreno LouAnne,
Sasaki Kazunari,
Fujiki Masato,
Kwon Choon Hyuck David,
Uso Teresa Diago,
D’Amico Giuseppe,
Aucejo Federico,
Eghtesad Bijan,
Miller Charles,
Quintini Cristiano,
Hashimoto Koji
Publication year - 2020
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.14004
Subject(s) - medicine , hemodynamics , hepatocellular carcinoma , liver transplantation , milan criteria , hazard ratio , gastroenterology , quartile , transplantation , proportional hazards model , blood flow , artery , cardiology , urology , confidence interval
Although experimental studies have reported that hepatic ischemia‐reperfusion injury promotes tumor growth and metastases, the impact of graft hemodynamics on the recurrence of hepatocellular carcinoma (HCC) after liver transplantation (LT) is unclear. To investigate the association between graft hemodynamics and HCC recurrence after LT, we conducted a retrospective analysis of 279 patients who underwent LT for HCC. Graft hemodynamics including portal vein flow (PVF), hepatic artery flow (HAF), and total hepatic flow (THF) was analyzed as a predictor of HCC recurrence, using competing risk regression analyses. The cutoff values of PVF, HAF, and THF were set at the lower quartile of distribution. A cumulative recurrence curve demonstrated that low THF (<1511 mL/min, P = .005) was significantly associated with increased recurrence, whereas neither low PVF (<1230 mL/min, P = .150) nor low HAF (<164 mL/min, P = .110) was significant. On multivariate analysis, outside Milan criteria (sub‐hazard ratio [SHR] = 3.742; P < .001), microvascular invasion (SHR = 3.698; P < .001), and low THF (SHR = 2.359; P = .010) were independently associated with increased HCC recurrence. In conclusion, our findings suggest that graft hemodynamics may play an important role in HCC recurrence after LT.