Premium
A novel model for evaluating the risk of hepatitis B recurrence after liver transplantation
Author(s) -
Xu Xiao,
Tu Zhenhua,
Wang Bei,
Ling Qi,
Zhang Lin,
Zhou Lin,
Jiang Guoping,
Wu Jian,
Zheng Shusen
Publication year - 2011
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/j.1478-3231.2011.02500.x
Subject(s) - medicine , liver transplantation , hepatocellular carcinoma , hepatitis b virus , gastroenterology , perioperative , hepatitis b , transplantation , cohort , risk factor , oncology , surgery , immunology , virus
Background: Hepatitis B virus (HBV) recurrence is a major risk factor affecting the long‐term survival of recipients for liver transplantation (LTx). Therefore, a model that can assess this risk before transplantation is highly desirable.Methods: One hundred and eighty‐five consecutive liver transplant recipients because of HBV‐related end‐stage liver diseases were selected. Their perioperative laboratory examination results, treatment protocol and the status of HBV recurrence were the primary parameters used to assess their risk of post‐transplant HBV recurrence. A model that may be generally used to evaluate the risk of post‐transplant HBV recurrence was thus established. A cohort for further validation and a cross‐validation were designed.Results: After a follow‐up time of 26.0 ± 10.8 months, the overall HBV recurrence rate was 8.6%. The 1‐, 2‐ and 3‐year cumulative survival rates were 98.5, 89.2 and 83.4% respectively. By correlation with the pretransplant presence of hepatocelluar carcinoma (HCC), serum HBV DNA level and status of antiviral treatment (AVT), the risk assessment model can be summarized using the following equation: RISK=−4.378+1.493 × HCC+1.286 × DNA−2.426 × AVT. The HBV recurrence rate and survival were found to be significantly different between the recipients with risk scores≤−2.8 and>−2.8. The model was well validated in this work.Conclusions: Pretransplant HBV DNA level, presence of HCC, AVT status and post‐transplant viral mutation were identified as the major risk factors associated with HBV recurrence after LTx. A novel model incorporating these factors could effectively evaluate the risk of post‐transplant HBV recurrence before transplantation.