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Updated: Mar 21, 2026
Transradial Access Chemoembolization for Hepatocellular Carcinoma Patients
Published on: September 20, 2020
Prior Trans-arterial chemoembolization - A protective factor against rapid HCV recurrence post liver transplant in
1Hepato-pancreatico-biliary and Liver Transplant, Sunshine Global Hospitals, Surat, India.
Insights
Pre-transplant transarterial chemoembolization (TACE) does not increase Hepatitis C Virus (HCV) recurrence after liver transplant. In fact, undergoing TACE may reduce the risk of rapid HCV recurrence post-transplant.
Area of Science:
- Hepatology
- Transplant Surgery
- Hepatocellular Carcinoma (HCC) Management
Background:
- Hepatitis C Virus (HCV) recurrence post-liver transplant is common, leading to severe complications.
- Limited research exists on the impact of pre-transplant hepatocellular carcinoma (HCC) therapies on HCV recurrence.
- This study investigates prognostic factors for HCV recurrence, focusing on pre-transplant HCC treatments.
Purpose of the Study:
- To identify prognostic factors associated with Hepatitis C Virus (HCV) recurrence after liver transplantation.
- To evaluate the impact of pre-transplant hepatocellular carcinoma (HCC) therapies on post-transplant HCV recurrence.
Main Methods:
- Retrospective analysis of 109 patients undergoing living donor liver transplantation for HCV-related HCC (July 2002-June 2012).
- HCV recurrence severity assessed using the ISHAK hepatitis activity index (HAI).
- Rapid recurrence defined as HAI > 4 at one year post-transplant; statistical analysis performed using SPSS v.21.
Main Results:
- Univariate analysis showed no pre-transplant transarterial chemoembolization (TACE), primary transplant, high MELD score, high pre-transplant viral load, and high AFP levels were associated with rapid HCV recurrence.
- Multivariate analysis revealed that patients who did not undergo TACE had a significantly higher risk of rapid HCV recurrence (OR 3.310, p=0.018).
- Of 61 patients who had TACE, 22 developed significant recurrence, while 39 did not.
Conclusions:
- Pre-transplant transarterial chemoembolization (TACE) does not increase the risk of Hepatitis C Virus (HCV) recurrence after liver transplantation.
- TACE may be beneficial in reducing the rate of rapid HCV recurrence post-transplant.
Background:
HCV recurrence after liver transplant is nearly universal and results in progressive fibrosis, cirrhosis, graft loss, retransplantation and mortality. There are very few studies comparing impact of pretransplant HCC therapies either as a bridge to transplant or to downstage like TACE, hepatectomy, RFA, PEI on HCV recurrence post transplant. Primary aim of the study was studying prognostic factors associated with HCV recurrence including pre transplant HCC therapies.
Material And Methods:
All the patients who have undergone living donor liver transplantation at Kaohsiung Chang gung memorial hospital, Taiwan for HCV related HCC between July 2002 and June 2012 were analyzed retrospectively. Severity of HCV histological recurrence was categorized according to the ISHAK hepatitis activity index score. Rapid HCV recurrence was defined ISHAK hepatitis activity index (HAI) score greater than 4 at one year. Statistical analysis was done using SPSS version 21. (IBM).
Results:
One hundred and nine patients with HCC associated with HCV undergo living donor liver transplant from July 2002 to June 2012. Median follow up time was 31 months. Forty nine patient had significant hepatitis c recurrence at the end of one year (HAI >4) and were included in study group.60 patients without significant hepatitis c recurrence were included in control group. On univariate analysis patients who did not undergo pre-transplant trans arterial chemoembolization (0.035), primary transplant (without prior hepatectomy) (p = 0.031), high meld score (p = 0.036), high viral load pretransplant (0.007), High AFP levels (0.013) were significantly associated with rapid histological recurrence of HCV (HAI greater than 4 at one year post transplant). Total 61 patient underwent prior transarterial chemoembolization, 22 of these patients developed significant HCV recurrence while 39 patient did not developed HCV recurrence. On multivariate analysis only patient who did not undergo TACE were significantly associated with rapid histological recurrence of HCV (odds ratio 3.310, p = 0.018 95% confidence interval 1.22-8.94).
Conclusion:
Prior TACE do not increase post transplant HCV recurrence but may be beneficial for it.
