Cargando…

Ischemic-Free Liver Transplantation Reduces the Recurrence of Hepatocellular Carcinoma After Liver Transplantation

Ischemia reperfusion injury (IRI) is an adverse factor for hepatocellular carcinoma (HCC) recurrence after liver transplantation. Ischemic-free liver transplantation (IFLT) is a novel transplant procedure that can largely reduce or even prevent IRI, but the clinical relevance of IFLT and the recurre...

Descripción completa

Detalles Bibliográficos
Autores principales: Tang, Yunhua, Wang, Tielong, Ju, Weiqiang, Li, Fangcong, Zhang, Qi, Chen, Zhitao, Gong, Jinlong, Zhao, Qiang, Wang, Dongping, Chen, Maogen, Guo, Zhiyong, He, Xiaoshun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8711268/
https://www.ncbi.nlm.nih.gov/pubmed/34966679
http://dx.doi.org/10.3389/fonc.2021.773535
_version_ 1784623335637778432
author Tang, Yunhua
Wang, Tielong
Ju, Weiqiang
Li, Fangcong
Zhang, Qi
Chen, Zhitao
Gong, Jinlong
Zhao, Qiang
Wang, Dongping
Chen, Maogen
Guo, Zhiyong
He, Xiaoshun
author_facet Tang, Yunhua
Wang, Tielong
Ju, Weiqiang
Li, Fangcong
Zhang, Qi
Chen, Zhitao
Gong, Jinlong
Zhao, Qiang
Wang, Dongping
Chen, Maogen
Guo, Zhiyong
He, Xiaoshun
author_sort Tang, Yunhua
collection PubMed
description Ischemia reperfusion injury (IRI) is an adverse factor for hepatocellular carcinoma (HCC) recurrence after liver transplantation. Ischemic-free liver transplantation (IFLT) is a novel transplant procedure that can largely reduce or even prevent IRI, but the clinical relevance of IFLT and the recurrence of HCC after liver transplantation are still unknown. This retrospective study compared survival outcomes, HCC recurrence, perioperative data and IRI severity following liver transplantation (LT). 30 patients received IFLT and 196 patients received conventional liver transplantation (CLT) were chosen for the entire cohort between June 2017 and August 2020. A 1:3 propensity score matching was performed, 30 IFLT recipients and 85 matched CLT patients were enrolled in propensity-matched cohorts. An univariate and multivariate Cox regression analysis was performed, and showed surgical procedure (CLT vs IFLT) was an independent prognostic factor (HR 3.728, 95% CI 1.172-11.861, P=0.026) for recurrence free survival (RFS) in HCC patients following liver transplantation. In the Kaplan–Meier analysis, the RFS rates at 1 and 3 years after LT in recipients with HCC in the IFLT group were significantly higher than those in the CLT group both in the entire cohort and propensity-matched cohort (P=0.006 and P=0.048, respectively). In addition, patients in the IFLT group had a lower serum lactate level, lower serum ALT level and serum AST level on postoperative Day 1. LT recipients with HCC in the IFLT group had a lower incidence of early allograft dysfunction than LT recipients with HCC in the CLT group. Histological analysis showed no obvious hepatocyte necrosis or apoptosis in IFLT group. In conclusion, IFLT can significantly reduce IRI damage and has the potential to be a useful strategy to reduce HCC recurrence after liver transplantation.
format Online
Article
Text
id pubmed-8711268
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-87112682021-12-28 Ischemic-Free Liver Transplantation Reduces the Recurrence of Hepatocellular Carcinoma After Liver Transplantation Tang, Yunhua Wang, Tielong Ju, Weiqiang Li, Fangcong Zhang, Qi Chen, Zhitao Gong, Jinlong Zhao, Qiang Wang, Dongping Chen, Maogen Guo, Zhiyong He, Xiaoshun Front Oncol Oncology Ischemia reperfusion injury (IRI) is an adverse factor for hepatocellular carcinoma (HCC) recurrence after liver transplantation. Ischemic-free liver transplantation (IFLT) is a novel transplant procedure that can largely reduce or even prevent IRI, but the clinical relevance of IFLT and the recurrence of HCC after liver transplantation are still unknown. This retrospective study compared survival outcomes, HCC recurrence, perioperative data and IRI severity following liver transplantation (LT). 30 patients received IFLT and 196 patients received conventional liver transplantation (CLT) were chosen for the entire cohort between June 2017 and August 2020. A 1:3 propensity score matching was performed, 30 IFLT recipients and 85 matched CLT patients were enrolled in propensity-matched cohorts. An univariate and multivariate Cox regression analysis was performed, and showed surgical procedure (CLT vs IFLT) was an independent prognostic factor (HR 3.728, 95% CI 1.172-11.861, P=0.026) for recurrence free survival (RFS) in HCC patients following liver transplantation. In the Kaplan–Meier analysis, the RFS rates at 1 and 3 years after LT in recipients with HCC in the IFLT group were significantly higher than those in the CLT group both in the entire cohort and propensity-matched cohort (P=0.006 and P=0.048, respectively). In addition, patients in the IFLT group had a lower serum lactate level, lower serum ALT level and serum AST level on postoperative Day 1. LT recipients with HCC in the IFLT group had a lower incidence of early allograft dysfunction than LT recipients with HCC in the CLT group. Histological analysis showed no obvious hepatocyte necrosis or apoptosis in IFLT group. In conclusion, IFLT can significantly reduce IRI damage and has the potential to be a useful strategy to reduce HCC recurrence after liver transplantation. Frontiers Media S.A. 2021-12-13 /pmc/articles/PMC8711268/ /pubmed/34966679 http://dx.doi.org/10.3389/fonc.2021.773535 Text en Copyright © 2021 Tang, Wang, Ju, Li, Zhang, Chen, Gong, Zhao, Wang, Chen, Guo and He https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Tang, Yunhua
Wang, Tielong
Ju, Weiqiang
Li, Fangcong
Zhang, Qi
Chen, Zhitao
Gong, Jinlong
Zhao, Qiang
Wang, Dongping
Chen, Maogen
Guo, Zhiyong
He, Xiaoshun
Ischemic-Free Liver Transplantation Reduces the Recurrence of Hepatocellular Carcinoma After Liver Transplantation
title Ischemic-Free Liver Transplantation Reduces the Recurrence of Hepatocellular Carcinoma After Liver Transplantation
title_full Ischemic-Free Liver Transplantation Reduces the Recurrence of Hepatocellular Carcinoma After Liver Transplantation
title_fullStr Ischemic-Free Liver Transplantation Reduces the Recurrence of Hepatocellular Carcinoma After Liver Transplantation
title_full_unstemmed Ischemic-Free Liver Transplantation Reduces the Recurrence of Hepatocellular Carcinoma After Liver Transplantation
title_short Ischemic-Free Liver Transplantation Reduces the Recurrence of Hepatocellular Carcinoma After Liver Transplantation
title_sort ischemic-free liver transplantation reduces the recurrence of hepatocellular carcinoma after liver transplantation
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8711268/
https://www.ncbi.nlm.nih.gov/pubmed/34966679
http://dx.doi.org/10.3389/fonc.2021.773535
work_keys_str_mv AT tangyunhua ischemicfreelivertransplantationreducestherecurrenceofhepatocellularcarcinomaafterlivertransplantation
AT wangtielong ischemicfreelivertransplantationreducestherecurrenceofhepatocellularcarcinomaafterlivertransplantation
AT juweiqiang ischemicfreelivertransplantationreducestherecurrenceofhepatocellularcarcinomaafterlivertransplantation
AT lifangcong ischemicfreelivertransplantationreducestherecurrenceofhepatocellularcarcinomaafterlivertransplantation
AT zhangqi ischemicfreelivertransplantationreducestherecurrenceofhepatocellularcarcinomaafterlivertransplantation
AT chenzhitao ischemicfreelivertransplantationreducestherecurrenceofhepatocellularcarcinomaafterlivertransplantation
AT gongjinlong ischemicfreelivertransplantationreducestherecurrenceofhepatocellularcarcinomaafterlivertransplantation
AT zhaoqiang ischemicfreelivertransplantationreducestherecurrenceofhepatocellularcarcinomaafterlivertransplantation
AT wangdongping ischemicfreelivertransplantationreducestherecurrenceofhepatocellularcarcinomaafterlivertransplantation
AT chenmaogen ischemicfreelivertransplantationreducestherecurrenceofhepatocellularcarcinomaafterlivertransplantation
AT guozhiyong ischemicfreelivertransplantationreducestherecurrenceofhepatocellularcarcinomaafterlivertransplantation
AT hexiaoshun ischemicfreelivertransplantationreducestherecurrenceofhepatocellularcarcinomaafterlivertransplantation