https://scholars.lib.ntu.edu.tw/handle/123456789/587743
Title: | Cross-match as an immuno-oncological risk factor for hepatocellular carcinoma recurrence and inferior survival after living donor liver transplantation: A call for further investigation | Authors: | CHENG-MAW HO REY-HENG HU YAO-MING WU MING-CHIH HO PO-HUANG LEE |
Issue Date: | 1-Jun-2021 | Journal Volume: | 25 | Journal Issue: | 1 | Source: | Annals of Hepato-Biliary-Pancreatic Surgery | Abstract: | Introduction: The success of immunotherapy for patients with hepatocellular carcinoma (HCC) suggest that immune dysregulation occurs in HCC patients. This warrants an immuno-oncological risk assessment in the platform of liver transplantation. Methods: This retrospective single-center study analyzed risk factors for—particularly cross-matching performed through conventional complement-dependent cytotoxicity cross-match tests—and the outcomes of HCC recurrence following living donor liver transplant. Results: A total of 71 patients were included. The median follow-up period was 29.1 months. Seventeen (23.9%) patients had posttransplant HCC recurrence, and their 1-, 3-, and 5-year survival rates were 70.6%, 25.7%, and 17.1%, respectively, which were inferior to those of patients without HCC recurrence (87.0%, 80.7%, and 77.2%, respectively [p < 0.001]). In addition to microvascular invasion, positive cross-match results for B cells at 37°C (B- 37ºC) or T cells at 4°C (T- 4ºC) was associated with inferior overall survival in multivariable analysis after adjustment for tumor status beyond Milan criteria and elevated alpha-fetoprotein levels. Rejection alone cannot be the mechanism underlying the effects of positive cross-match results on patient outcomes. Adjusted survival curves suggested that positive cross-match B- 37ºC or T- 4ºC was associated with inferior recurrence-free and patient survival, but the robustness of the finding was limited by insufficient power. Conclusions: Additional large-scale studies are required to validate positive cross-match as an immuno-oncological factor associated with HCC recurrence and inferior patient survival. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/587743 | ISSN: | 25085778 | DOI: | 10.14701/ahbps.LV-OP-1-6 |
Appears in Collections: | 醫學系 |
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