Post-transplant hepatitis B virus reactivation impacts the prognosis of patients with hepatitis B-related hepatocellular carcinoma: a dual-centre retrospective cohort study in China

作者：Huigang Li, Di Lu, Jingyan Chen, Junchi Zhang, Jianyong Zhuo, Zuyuan Lin, Chenghao Cao, Wei Feng Shen, Chiyu He, Hao Chen, Zhihang Hu, Yiyang Sun, Xuyong Wei, Zhuang Li, Shusen Zheng, Xiao Xu · 发表于：International Journal of Surgery · 年份：2024 · DOI：10.1097/js9.0000000000001141 · 被引用次数：13 · 研究领域：Hepatitis B Virus Studies、Hepatocellular Carcinoma Treatment and Prognosis、Organ Transplantation Techniques and Outcomes

BACKGROUND: Highly active hepatitis B virus (HBV) is known to be associated with poor outcomes in patients with hepatocellular carcinoma (HCC). This study aims to investigate the relationship between HBV status and HCC recurrence after liver transplantation. METHODS: The study retrospectively analyzed HCC patients undergoing liver transplantation in two centres between January 2015 and December 2020. The authors reviewed post-transplant HBV status and its association with outcomes. RESULTS: The prognosis of recipients with hepatitis B surface antigen (HBsAg) reappearance ( n =58) was poorer than those with HBsAg persistent negative ( n =351) and positive ( n =53). In HBsAg persistent positive group, recipients with HBV DNA reappearance or greater than 10-fold increase above baseline had worse outcomes than those without ( P <0.01). HBV reactivation was defined as (a) HBsAg reappearance or (b) HBV DNA reappearance or greater than 10-fold increase above baseline. After propensity score matching, the 5-year overall survival rate and recurrence-free survival rate after liver transplantation in recipients with HBV reactivation were significantly lower than those without (32.0% vs. 62.3%; P <0.01, and 16.4% vs. 63.1%; P <0.01, respectively). Moreover, HBV reactivation was significantly related to post-transplant HCC recurrence, especially lung metastasis. Cox regression analysis revealed that beyond Milan criteria, microvascular invasion and HBsAg-positive graft were independent ri...