Effect of HBV-HDV co-infection on HBV-HCC co-recurrence in patients undergoing living donor liver transplantation
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ORIGINAL ARTICLE
Effect of HBV‑HDV co‑infection on HBV‑HCC co‑recurrence in patients undergoing living donor liver transplantation Adil Baskiran1 · Sami Akbulut1 · Tevfik Tolga Sahin1 · Cemalettin Koc1 · Serdar Karakas1 · Volkan Ince1 · Cihan Yurdaydin2 · Sezai Yilmaz1 Received: 9 June 2020 / Accepted: 20 August 2020 © Asian Pacific Association for the Study of the Liver 2020
Abstract Purpose To evaluate the effect of hepatitis D virus (HDV) on hepatitis B virus-hepatocellular carcinoma (HBV-HCC) co-recurrence in patients undergoing living donor liver transplantation (LDLT) for HBV alone or HBV-HDV coinfection. Methods Between 2002 and 2019, 254 HBV-HCC patients underwent LDLT. The patients were divided into two groups after the application of the exclusion criteria: HBV-HCC (Group B; n = 163) and HBV-HDV-HCC (Group D; n = 31). First, the B and D groups were compared in terms of demographic and clinical parameters. Second, patients with (n = 16) and without (n = 178) post-transplant HBV-HCC co-recurrences were grouped and compared in terms of the same parameters. Results Although the risk of HBV-HCC co-recurrence in group D was 4.99-fold higher than in group B, the risk of HBV recurrence alone in group D was 12.5-fold lower than in group B. The AFP (OR = 4.4), Milan criteria (beyond; OR = 18.8), and HDV (OR = 8.1) were identified as the independent risk factors affecting post-transplant HBV-HCC co-recurrence. The Milan criteria (OR = 2.1) and HBV-HCC co-recurrence (OR = 10.9) were identified as the risk factors affecting post-transplant mortality. HBV-HCC co-recurrence developed in 26.5% of patients in Group B and 100% in Group D (OR = 40; p = 0.001). HCC recurrence alone developed in 10% of patients without HBV recurrence in group B and 0% of patients without HBV recurrence in group D (OR = 5.7). Conclusion This study showed that the risk of HBV recurrence alone was reduced by 12.5-fold in the presence of HDV; however, the HCC recurrence occurred in all patients with HDV when HBV recurrence developed. Keywords Liver transplantation · HCC · HBV · HDV · HBV recurrence alone · HCC recurrence alone · HBV-HCC co-recurrence
* Sami Akbulut [email protected]
Cihan Yurdaydin [email protected]
Adil Baskiran [email protected]
Sezai Yilmaz [email protected]
Tevfik Tolga Sahin [email protected]
1
Department of Surgery, Faculty of Medicine, Liver Transplant Institute, Inonu University, Elazig Yolu 10. Km, 44280 Malatya, Turkey
2
Department of Gastroenterology, Faculty of Medicine, Koc University, 34450 Istanbul, Turkey
Cemalettin Koc [email protected] Serdar Karakas [email protected] Volkan Ince [email protected]
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Introduction Since the first successful liver transplantation (LT) was performed in 1967, LT has become the gold standard treatment choice for many liver diseases, including end-stage liver diseases. The indications for LT differ in the east and west of the world, related to the lifestyle and sociocultural
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