A Meta-Analysis on the Rate of Hepatocellular Carcinoma Recurrence after Liver Transplant and Associations to Etiology, Alpha-Fetoprotein, Income and Ethnicity
Hepatocellular carcinoma (HCC) recurrence after liver transplant is associated with a poor prognosis and significantly increases morbidity and mortality among liver transplant patients. Therefore, this meta-analysis aims to evaluate the overall prevalence of HCC recurrence following liver transplant...
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doaj-1316fcc6cbe54a42a1c90c892ca297e72021-01-12T00:02:55ZengMDPI AGJournal of Clinical Medicine2077-03832021-01-011023823810.3390/jcm10020238A Meta-Analysis on the Rate of Hepatocellular Carcinoma Recurrence after Liver Transplant and Associations to Etiology, Alpha-Fetoprotein, Income and EthnicityDarren J. H. Tan0Chloe Wong1Cheng Han Ng2Chen Wei Poh3Sneha Rajiv Jain4Daniel Q. Huang5Mark D. Muthiah6Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, SingaporeYong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, SingaporeYong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, SingaporeYong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, SingaporeYong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, SingaporeYong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, SingaporeYong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, SingaporeHepatocellular carcinoma (HCC) recurrence after liver transplant is associated with a poor prognosis and significantly increases morbidity and mortality among liver transplant patients. Therefore, this meta-analysis aims to evaluate the overall prevalence of HCC recurrence following liver transplant. Medline and Embase databases were searched, and a meta-analysis of proportions was conducted. Observational studies reporting the prevalence of recurrent hepatocellular carcinoma (HCC) after liver transplant were included, with the analysis being stratified by adherence to Milan criteria, ethnicity, socio-economic status, alpha fetoprotein (AFP) levels, living donor vs. deceased donor, and the underlying aetiology of the liver disease. A meta-regression on the date of the study completion was also performed. Of a total 40,495 patients, 3888 developed an HCC recurrence. The overall prevalence of recurrent HCC was 13% (CI: 0.12–0.15). Patients beyond the Milan criteria (MC) were more likely to recur than patients within MC. Asian populations had the greatest prevalence of HCC recurrence (19%; CI: 0.15–0.24) when compared to Western (12%; CI: 0.11–0.13) and Latin American populations (11%; CI: 0.09–0.14). The prevalence of recurrent HCC was the highest in patients infected with hepatitis B virus (HBV) (18%; CI: 0.11–0.27) compared to other aetiologies. A higher AFP also resulted in an increased recurrence. This highlights interesting differences based on ethnicity, income, and aetiology, and further studies are needed to determine the reasons for the disparity.https://www.mdpi.com/2077-0383/10/2/238deceased donor liver transplantethnicityepidemiologyHCC recurrenceliving donor liver transplantmeta-analysis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Darren J. H. Tan Chloe Wong Cheng Han Ng Chen Wei Poh Sneha Rajiv Jain Daniel Q. Huang Mark D. Muthiah |
spellingShingle |
Darren J. H. Tan Chloe Wong Cheng Han Ng Chen Wei Poh Sneha Rajiv Jain Daniel Q. Huang Mark D. Muthiah A Meta-Analysis on the Rate of Hepatocellular Carcinoma Recurrence after Liver Transplant and Associations to Etiology, Alpha-Fetoprotein, Income and Ethnicity Journal of Clinical Medicine deceased donor liver transplant ethnicity epidemiology HCC recurrence living donor liver transplant meta-analysis |
author_facet |
Darren J. H. Tan Chloe Wong Cheng Han Ng Chen Wei Poh Sneha Rajiv Jain Daniel Q. Huang Mark D. Muthiah |
author_sort |
Darren J. H. Tan |
title |
A Meta-Analysis on the Rate of Hepatocellular Carcinoma Recurrence after Liver Transplant and Associations to Etiology, Alpha-Fetoprotein, Income and Ethnicity |
title_short |
A Meta-Analysis on the Rate of Hepatocellular Carcinoma Recurrence after Liver Transplant and Associations to Etiology, Alpha-Fetoprotein, Income and Ethnicity |
title_full |
A Meta-Analysis on the Rate of Hepatocellular Carcinoma Recurrence after Liver Transplant and Associations to Etiology, Alpha-Fetoprotein, Income and Ethnicity |
title_fullStr |
A Meta-Analysis on the Rate of Hepatocellular Carcinoma Recurrence after Liver Transplant and Associations to Etiology, Alpha-Fetoprotein, Income and Ethnicity |
title_full_unstemmed |
A Meta-Analysis on the Rate of Hepatocellular Carcinoma Recurrence after Liver Transplant and Associations to Etiology, Alpha-Fetoprotein, Income and Ethnicity |
title_sort |
meta-analysis on the rate of hepatocellular carcinoma recurrence after liver transplant and associations to etiology, alpha-fetoprotein, income and ethnicity |
publisher |
MDPI AG |
series |
Journal of Clinical Medicine |
issn |
2077-0383 |
publishDate |
2021-01-01 |
description |
Hepatocellular carcinoma (HCC) recurrence after liver transplant is associated with a poor prognosis and significantly increases morbidity and mortality among liver transplant patients. Therefore, this meta-analysis aims to evaluate the overall prevalence of HCC recurrence following liver transplant. Medline and Embase databases were searched, and a meta-analysis of proportions was conducted. Observational studies reporting the prevalence of recurrent hepatocellular carcinoma (HCC) after liver transplant were included, with the analysis being stratified by adherence to Milan criteria, ethnicity, socio-economic status, alpha fetoprotein (AFP) levels, living donor vs. deceased donor, and the underlying aetiology of the liver disease. A meta-regression on the date of the study completion was also performed. Of a total 40,495 patients, 3888 developed an HCC recurrence. The overall prevalence of recurrent HCC was 13% (CI: 0.12–0.15). Patients beyond the Milan criteria (MC) were more likely to recur than patients within MC. Asian populations had the greatest prevalence of HCC recurrence (19%; CI: 0.15–0.24) when compared to Western (12%; CI: 0.11–0.13) and Latin American populations (11%; CI: 0.09–0.14). The prevalence of recurrent HCC was the highest in patients infected with hepatitis B virus (HBV) (18%; CI: 0.11–0.27) compared to other aetiologies. A higher AFP also resulted in an increased recurrence. This highlights interesting differences based on ethnicity, income, and aetiology, and further studies are needed to determine the reasons for the disparity. |
topic |
deceased donor liver transplant ethnicity epidemiology HCC recurrence living donor liver transplant meta-analysis |
url |
https://www.mdpi.com/2077-0383/10/2/238 |
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