Application of hepatitis B surface antigen positive graft in hepatic carcinoma patients receiving liver transplantation

Abstract

Objective To identify the long-term survival of patients with hepatic carcinoma who received hepatitis B surface antigen (HBsAg) positive donor livers. Method A total of 195 patients were enrolled in the study. They were all diagnosed as having hepatic carcinoma with malignant thrombus in portal vein pre-operation and received liver transplantations between 1999 and 2014. The long-term survival between the patients who received HBsAg positive grafts and those who received HBsAg negative grafts was compared. Result There were no differences in ages, preoperative tumor stages and postoperative mortality between the two groups. There was significant difference in survival time between the two groups (Z=-2.038, P=0.042), with the median survival time of 8.83 months (2.50-24.80 months) in HBsAg positive graft group and 13.12 months (6.50-27.65 months) in HBsAg negative graft group, respectively. The long-term survival rate in HBsAg positive graft group was 48% and that in HBsAg negative graft group was 34.7% (P=0.740, χ2=0.110). However, the proportion of deaths due to recurrence of tumor was high to 75.8% in all causes. Conclusion To prolong the survival time, it is safe and feasible to receive HBsAg positive donor livers in patients with hepatic carcinoma in late stage. However, tumor recurrence was still the main causes of deaths in patients post-operation because of the advanced tumor conditions pre-operation. Key words: Hepatic carcinoma; Liver transplantation; Survival