O130 DONOR CHARACTERISTICS AND THE RISK OF HEPATOCELLULAR CARCINOMA RECURRENCE AFTER LIVER TRANSPLANTATION

Abstract

Background and Aims: Hepatocellular carcinoma (HCC) recurrence after liver transplantation occurs in 10–15% of patients. To date, studies assessing the risk of post-transplant HCC recurrence have focused on recipients’ characteristics. Here, we investigate the impact of donor characteristics and liver graft quality on the risk of post-liver transplantation HCC recurrence. Methods: Using the Scientific Registry of Transplant Recipients (SRTR), we included adult patients granted with an exception for HCC diagnosis and receiving a liver transplant between 2004 and 2011. Post-transplant HCC recurrence was determined by using malignancy follow-up data and scrutinizing causes of death files (as validated by Samoylova ML et al. Liver Transplant 2013). A multivariate Cox proportional-hazards regression was fitted, evaluating the role of donor characteristics on the risk of posttransplant HCC recurrence, after adjusting for confounding factors such as tumour size and number, AFP and transplant centre. Results: 9724 recipients were included. The 5-year cumulative recurrence rate was 7.8% (95%CI: 7.2–8.5). After adjusting for confounders, patients receiving a graft from a donor older than 60 years (hazard ratio (HR) 1.42, 95%CI: 1.16–1.74, p = 0.001), a donor with a history of diabetes (HR 1.48, 95%CI: 1.18–1.86, p = 0.001) and a donor with obesity class II (body mass index >35kg/m) or more (HR 1.32, 95%CI: 1.03–1.70, p = 0.027), had significantly higher post-transplant HCC recurrence rates. The proportionalhazards Shoenfeld’s residuals test P value was 0.619. Conclusions: In addition to tumour characteristics, donor-related factors such as elevated donor age, increasing body mass index, and diabetes should be taken into account when predicting the risk of post-liver transplant HCC recurrence.