scholarly journals Role of Allelic Imbalance in Predicting Hepatocellular Carcinoma (HCC) Recurrence Risk After Liver Transplant

2019 ◽  
Vol 24 ◽  
pp. 223-233 ◽  
Author(s):  
Duilio Pagano ◽  
Floriana Barbera ◽  
Pier Giulio Conaldi ◽  
Aurelio Seidita ◽  
Fabrizio Di Francesco ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplant ◽  
Allelic Imbalance ◽  
Recurrence Risk ◽  
Hcc Recurrence

The interplay between gut microbiota and the immune system in liver transplant recipients and its role in infections

2021 ◽  
Author(s):  
Giuseppe Ancona ◽  
Laura Alagna ◽  
Andrea Lombardi ◽  
Emanuele Palomba ◽  
Valeria Castelli ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Immune System ◽  
Liver Disease ◽  
Gut Microbiota ◽  
Liver Transplant ◽  
Bacterial Infections ◽  
Multidrug Resistant ◽  
Transplant Recipients ◽  
Liver Transplant Recipients

Liver transplantation (LT) is a life-saving strategy for patients with end-stage liver disease, hepatocellular carcinoma and acute liver failure. LT success can be hampered by several short-term and long-term complications. Among them, bacterial infections, especially due to multidrug-resistant germs, are particularly frequent with a prevalence between 19 and 33% in the first 100 days after transplantation. In the last decades, a number of studies have highlighted how gut microbiota (GM) is involved in several essential functions to ensure the intestinal homeostasis, becoming one of the most important virtual metabolic organs. GM works through different axes with other organs, and the gut-liver axis is among the most relevant and investigated ones. Any alteration or disruption of GM is defined as dysbiosis. Peculiar phenotypes of GM dysbiosis have been associated to several liver conditions and complications, such as chronic hepatitis, fatty liver disease, cirrhosis and hepatocellular carcinoma. Moreover, there is growing evidence of the crucial role of GM in shaping the immune response, both locally and systemically, against pathogens. This paves the way to the manipulation of GM as a therapeutic instrument to modulate the infectious risk and outcome. In this minireview we provide an overview of the current understanding on the interplay between gut microbiota and the immune system in liver transplant recipients and the role of the former in infections.

Hepatocellular carcinoma recurrence after direct-acting antiviral therapy: an individual patient data meta-analysis

Gut ◽  
2021 ◽  
pp. gutjnl-2020-323663
Author(s):  
Victor Sapena ◽  
Marco Enea ◽  
Ferran Torres ◽  
Ciro Celsa ◽  
Jose Rios ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Propensity Score ◽  
Individual Patient Data ◽  
Meta Analysis ◽  
Recurrence Risk ◽  
Patient Data ◽  
Death Risk ◽  
Significant Difference ◽  
Direct Acting ◽  
Hcc Recurrence

ObjectiveThe benefit of direct-acting antivirals (DAAs) against HCV following successful treatment of hepatocellular carcinoma (HCC) remains controversial. This meta-analysis of individual patient data assessed HCC recurrence risk following DAA administration.DesignWe pooled the data of 977 consecutive patients from 21 studies of HCV-related cirrhosis and HCC, who achieved complete radiological response after surgical/locoregional treatments and received DAAs (DAA group). Recurrence or death risk was expressed as HCC recurrence or death per 100 person-years (100PY). Propensity score-matched patients from the ITA.LI.CA. cohort (n=328) served as DAA-unexposed controls (no-DAA group). Risk factors for HCC recurrence were identified using random-effects Poisson.ResultsRecurrence rate and death risk per 100PY in DAA-treated patients were 20 (95% CI 13.9 to 29.8, I2=74.6%) and 5.7 (2.5 to 15.3, I2=54.3), respectively. Predictive factors for recurrence were alpha-fetoprotein logarithm (relative risk (RR)=1.11, 95% CI 1.03 to 1.19; p=0.01, per 1 log of ng/mL), HCC recurrence history pre-DAA initiation (RR=1.11, 95% CI 1.07 to 1.16; p<0.001), performance status (2 vs 0, RR=4.35, 95% CI 1.54 to 11.11; 2 vs 1, RR=3.7, 95% CI 1.3 to 11.11; p=0.01) and tumour burden pre-HCC treatment (multifocal vs solitary nodule, RR=1.75, 95% CI 1.25 to 2.43; p<0.001). No significant difference was observed in RR between the DAA-exposed and DAA-unexposed groups in propensity score-matched patients (RR=0.64, 95% CI 0.37 to 1.1; p=0.1).ConclusionEffects of DAA exposure on HCC recurrence risk remain inconclusive. Active clinical and radiological follow-up of patients with HCC after HCV eradication with DAA is justified.

scholarly journals mTOR Expression in Liver Transplant Candidates with Hepatocellular Carcinoma: Impact on Histological Features and Tumour Recurrence

2019 ◽  
Vol 20 (2) ◽  
pp. 336 ◽  
Author(s):  
Marta Guerrero ◽  
Gustavo Ferrín ◽  
Manuel Rodríguez-Perálvarez ◽  
Sandra González-Rubio ◽  
Marina Sánchez-Frías ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplant ◽  
Cox Regression ◽  
Cell Signalling ◽  
Mtor Pathway ◽  
Tumour Recurrence ◽  
Recurrence Rates ◽  
Explanted Liver ◽  
Peritumoral Tissue ◽  
Hcc Recurrence

(1) Background: The mammalian target of rapamycin (mTOR) pathway activation is critical for hepatocellular carcinoma (HCC) progression. We aimed to evaluate the mTOR tissue expression in liver transplant (LT) patients and to analyse its influence on post-LT outcomes. (2) Methods: Prospective study including a cohort of HCC patients who underwent LT (2012–2015). MTOR pathway expression was evaluated in the explanted liver by using the “PathScan Intracellular Signalling Array Kit” (Cell Signalling). Kaplan-Meier and Cox regression analyses were performed to evaluate post-LT HCC recurrence. (3) Results: Forty-nine patients were included (average age 56.4 ± 6, 14.3% females). Phospho-mTOR (Ser2448) was over-expressed in peritumoral tissue as compared with tumoral tissue (ΔSignal 22.2%; p < 0.001). The mTOR activators were also increased in peritumoral tissue (phospho-Akt (Thr308) ΔSignal 18.2%, p = 0.004; phospho-AMPKa (Thr172) ΔSignal 56.3%, p < 0.001), as they were the downstream effectors responsible for cell growth/survival (phospho-p70S6K (Thr389) ΔSignal 33.3%, p < 0.001 and phospho-S6RP (Ser235/236) ΔSignal 54.6%, p < 0.001). MTOR expression was increased in patients with multinodular HCC (tumoral p = 0.01; peritumoral p = 0.001). Increased phospho-mTOR in tumoral tissue was associated with higher HCC recurrence rates after LT (23.8% vs. 5.9% at 24 months, p = 0.04). (4) Conclusion: mTOR pathway is over-expressed in patients with multinodular HCC and is it associated with increased post-LT tumour recurrence rates.

The role of preoperative albumin‐bilirubin grade for oncological risk stratification in liver transplant patients with hepatocellular carcinoma

2019 ◽  
Vol 120 (7) ◽  
pp. 1126-1136 ◽  
Author(s):  
Arno Kornberg ◽  
Ulrike Witt ◽  
Martina Schernhammer ◽  
Jennifer Kornberg ◽  
Katharina Müller ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Risk Stratification ◽  
Liver Transplant ◽  
Transplant Patients ◽  
Preoperative Albumin

scholarly journals The Role of Antiviral Therapy for HBV-Related Hepatocellular Carcinoma

2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Liang-He Yu ◽  
Nan Li ◽  
Shu-Qun Cheng
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Function ◽  
Antiviral Therapy ◽  
Tumor Recurrence ◽  
De Novo ◽  
Antiviral Treatment ◽  
Late Recurrence ◽  
B Virus ◽  
Hcc Recurrence

Hepatocellular carcinoma (HCC) is a highly prevalent and lethal cancer worldwide; despite the curative treatment for HCC, the rate of tumor recurrence after hepatectomy remains high. Tumor recurrence can occur early (<2 years) or late (>2 years) as metastases or de novo tumors. Several tumor factors were associated with HCC recurrence; high hepatitis B virus (HBV) load is the major risk factor for late recurrence of HCC after resection. Preoperative antiviral therapy improves liver function, and postoperative reduce HCC recurrence. In this paper, we focus on antiviral treatment to improve the liver function, prevent recurrence, and lengthen the overall survival for HBV-related HCC.

scholarly journals A Novel Blood Index-Based Model to Predict Hepatitis B Virus-Associated Hepatocellular Carcinoma Recurrence After Curative Hepatectomy: Guidance on Adjuvant Transcatheter Arterial Chemoembolization Choice

2021 ◽  
Vol 11 ◽  
Author(s):  
Yiping Zou ◽  
Zhihong Chen ◽  
Qi Lou ◽  
Hongwei Han ◽  
Yuanpeng Zhang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Transcatheter Arterial Chemoembolization ◽  
Recurrence Risk ◽  
Blood Index ◽  
B Virus ◽  
Hcc Recurrence ◽  
Curative Hepatectomy ◽  
Arterial Chemoembolization

BackgroundPostoperative recurrence is a significant obstacle in hepatocellular carcinoma (HCC) treatment. This study aimed to construct a blood index-based model to predict hepatitis B virus-associated HCC (HBV-HCC) recurrence after curative hepatectomy.MethodsA total of 370 patients who received initially curative hepatectomy for HBV-HCC were included in this study. A novel blood index signature (BIS) was identified and systematically analyzed for its recurrence predictive value. Following this, multivariate Cox regression analysis was performed to build a blood index-based nomogram.ResultsA BIS based on the aminotransferase-to-platelet ratio index and a systemic inflammatory response index was used to construct a nomogram. The model showed good clinical applicability and reliability. Notably, the patients in the high recurrence risk group tended to benefit from adjuvant transcatheter arterial chemoembolization (TACE).ConclusionA reliable model was constructed to predict the HBV-HCC recurrence after curative hepatectomy. This model can guide the surgeons in selecting patients with high recurrence risk patients who may benefit from adjuvant TACE.

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