Role of Inflammatory Markers in Predicting Hepatocellular Carcinoma Recurrence after Liver Transplantation

Abstract

Regarding liver transplantation, It is considered a highly effective therapy for early-stage HCC because it offers optimal treatment of both the underlying liver disease and the tumor, and is associated with excellent long-term survival rates. Despite using the morphologic criteria, such as the Milan criteria to select HCC patients for LT, tumor recurrence (TR) still occurs in 15% to 20% of cases, being associated with an unfavorable prognosis. Measurement of inflammatory markers represents a significant tool to asses risk of HCC recurrence post LT, as the pro inflammatory effects of systemic inflammatory response (SIR) have been linked with HCC. This study was conducted to assess the role of the inflammatory indices as prognostic markers for HCC recurrence post liver transplantation and to compare these markers with the standard parameters as AFP and micro-vascular invasion as regard HCC recurrence post liver transplantation.

To fulfill the aim of this study which was conducted at Ain-Shams University organ transplant (ASCOT) unit, 100 participants with HCC were included and characterized by the following: Inclusion Criteria: All patients aged (18-60) years fulfilled Milan/Modified San Fransisco Criteria, underwent Living donor liver transplantation LDLT during the study period from March 2008 till March 2018. Study Procedures: Data was retrieved from the file system of the included patients stressing on the following: i. Full history taking and examination ii. Laboratory investigations including CBC with differential (commenting on absolute neutrophil, lymphocyte and platelet count to calculate PLR, NLR), AFP and CRP iii. Pre-operative Child-Turcotte-Pugh Scoring System iv. Pre-operative model for end stage liver disease (MELD) v. Pre-operative Radiological Assesment vi. Post operative Histological confirmation Results of the current study showed the total number of the studied patients are 100, 91 males and 9 females with mean age (52.26 ± 6.27) years.