Time to transplantation as predictor of hepatocellular recurrence after liver transplantation: a retrospective cohort study

Abstract

Hepatocellular recurrence after liver transplantation (LTx) is a major cause of morbidity and mortality. We aimed to investigate the association between waiting time and hepatocellular carcinoma (HCC) recurrence in patients undergoing LTx for HCC. We studied 250 patients who underwent LTx between 2007-2015. Survival and recurrence curves were calculated according to the Kaplan–Meier method and compared by the log-rank test. Univariate hazard ratios for predictors of post-LTx HCC recurrence were determined by Cox proportional hazards regressions. There were no significant differences in recurrence rates when stratified by wait time to transplant. There were also no significant differences in rates of recurrence when the short (< 165 days) and long (> 335 days) wait-time groups were combined, although in this pooled group the 1-year and 5-year cumulative likelihoods of HCC recurrence were higher than in the group with a wait time of 165-334 days. Other predictors of recurrence were microvascular invasion, explant beyond Milan Brazil criteria and tumor diameter ≥ 2.6. This study found no association between wait time to transplantation and recurrence rates in patients who received LTx for HCC and confirmed that variables associated with tumor biology are associated with HCC recurrence.