Department of Surgery, Thomas Jefferson University Hospital, Jefferson University Hospitals, Philadelphia, PA, United States.
Department of Gastroenterology, Thomas Jefferson University Hospital, Jefferson University Hospitals, Philadelphia, PA, United States.
Transpl Int. 2022 Jul 5;35:10175. doi: 10.3389/ti.2022.10175. eCollection 2022.
Non-alcoholic steatohepatitis (NASH)-related hepatocellular carcinoma (HCC) has become the second leading cause of HCC-related liver transplantation in the United States. This study investigated post-transplant recurrence and survival for patients transplanted for NASH-related HCC compared to non-NASH HCC etiologies. Retrospective review of the United Network for Organ Sharing (UNOS) Organ Procurement and Transplantation Network (OPTN) database identified 7,461 patients with HCC-1,405 with underlying NASH and 6,086 with non-NASH underlying diseases. After propensity score matching (PSM) to account for patient- and tumor-related confounders 1,175 remained in each group. Primary outcomes assessed were recurrence rate and recurrence-free survival. Recurrent malignancy at 5 years post-transplant was lower in NASH compared to non-NASH patients (5.80 vs. 9.41%, = 0.01). Recurrence-free survival, however, was similar at 5 years between groups. Patients with NASH-related HCC were less likely to have post-transplant recurrence than their non-NASH counterparts, although recurrence-free survival was similar at 5 years.
非酒精性脂肪性肝炎（NASH）相关肝细胞癌（HCC）已成为美国 HCC 相关肝移植的第二大主要原因。本研究调查了与非 NASH HCC 病因相比，移植治疗 NASH 相关 HCC 患者的移植后复发和生存情况。对美国器官共享联合网络（UNOS）器官获取和移植网络（OPTN）数据库的回顾性分析确定了 7461 例 HCC 患者，其中 1405 例为 NASH 基础疾病，6086 例为非 NASH 基础疾病。在对患者和肿瘤相关混杂因素进行倾向评分匹配（PSM）后，每组仍有 1175 例。主要结局评估为复发率和无复发生存率。移植后 5 年时，NASH 患者的复发性恶性肿瘤发生率低于非 NASH 患者（5.80% vs. 9.41%， = 0.01）。然而，两组之间 5 年的无复发生存率相似。与非 NASH 患者相比，NASH 相关 HCC 患者的移植后复发可能性较小，但 5 年无复发生存率相似。
