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. 2013 Apr 16;8(4):e61620.
doi: 10.1371/journal.pone.0061620. Print 2013.

Survival in liver transplant recipients with hepatitis B- or hepatitis C-associated hepatocellular carcinoma: the Chinese experience from 1999 to 2010

Zhenhua Hu  1 , Jie Zhou, Haibo Wang, Min Zhang, Shaogang Li, Yuzhou Huang, Jian Wu, Zhiwei Li, Lin Zhou, Shusen Zheng
Affiliations

Survival in liver transplant recipients with hepatitis B- or hepatitis C-associated hepatocellular carcinoma: the Chinese experience from 1999 to 2010

Zhenhua Hu et al. PLoS One. .

Abstract

Background: Hepatitis B virus-associated hepatocellular carcinoma (HBV-HCC) and hepatitis C virus (HCV)-HCC are the main indications for liver transplantation. We compared differences in survival outcomes between these two conditions.

Methods and findings: The China Liver Transplant Registry (CLTR) contains data collated from all transplants performed in 86 liver transplantation centers across China. We analyzed CLTR data from January 1999 to December 2010. In all, 7,658 patients (7,162 with HBV-HCC and 496 with HCV-HCC) were included in this study. Clinical characteristics were compared between the HBV-HCC and HCV-HCC groups; Kaplan-Meier analysis was used to calculate the overall, tumor-free and hepatitis-free survival rates. The 1-year, 3-year and 5-year overall survival was significantly higher in HBV-HCC recipients than in HCV-HCC recipients (76.65%, 56.61% and 49.10% vs. 64.59%, 42.78% and 39.20%, respectively; P<0.001). The corresponding tumor-free survival rates (63.55%, 47.37%, 40.99% vs. 56.84%, 38.04%, 35.66%, respectively) and hepatitis-free survival rates (75.49%, 54.84%, 47.34% vs. 63.87%, 42.15%, 39.33%, respectively) were both superior in HBV-HCC recipients (both P<0.001). Multivariate analyses identified hepatitis, preoperative alpha-fetoprotein (AFP) level, size of largest tumor, number of tumor nodules, TNM stage, vascular invasion and preoperative model for end-stage liver disease (MELD) score as independent predictors of overall, tumor-free and hepatitis-free survival.

Conclusions: Survival outcomes after liver transplantation were significantly better in HBV-HCC patients than in HCV-HCC patients. This finding may be used to guide donor liver allocation in transplantation programs.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Flow chart of patient selection.
Figure 2
Figure 2. Overall survival rates after liver transplantation (LT) in patients with hepatitis B virus (HBV)-associated hepatocellular carcinoma (HCC) and hepatitis C virus (HCV)-associated HCC who met the Hangzhou criteria.
Figure 3
Figure 3. Tumor-free survival rates after liver transplantation (LT) in patients with hepatitis B virus (HBV)-associated hepatocellular carcinoma (HCC) and hepatitis C virus (HCV)-associated HCC who met the Hangzhou criteria.
Figure 4
Figure 4. Hepatitis-free survival rates after liver transplantation (LT) in patients with hepatitis B virus (HBV)-associated hepatocellular carcinoma (HCC) and hepatitis C virus (HCV)-associated HCC who met the Hangzhou criteria.
See this image and copyright information in PMC

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