The Matching Status Between Donor and Recipient Hepatitis B Seroepidemiology Makes a Difference in Liver

Di Lu1,2, Fan Yang1,2, Jianyong Zhuo1,2

  • 1Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.

Insights

Antibody to hepatitis B core antigen (HBcAb) in liver transplant recipients indicates a higher risk of hepatocellular carcinoma (HCC) recurrence. A new nomogram incorporating HBcAb and donor HBsAg status aids in predicting recurrence, improving post-transplant outcomes.

Area of Science:

  • Hepatology
  • Transplant Surgery
  • Oncology

Background:

  • Hepatocellular carcinoma (HCC) is a leading cause of liver cancer.
  • Liver transplantation is a curative option for select HCC patients.
  • Prognostic factors for post-transplant HCC recurrence require further elucidation.

Purpose of the Study:

  • To evaluate the prognostic value of antibody to hepatitis B core antigen (HBcAb) and other hepatitis B seroepidemiological markers in HCC transplantation.
  • To develop a predictive model for post-transplant HCC recurrence risk.

Main Methods:

  • Analysis of a national liver transplant registry data.
  • Retrospective study of HCC patients undergoing liver transplantation.
  • Development and validation of a risk-predicting nomogram using training and validation cohorts.

Main Results:

  • Positive HBcAb in recipients correlated with increased HCC recurrence across various etiologies.
  • Donor hepatitis B surface antigen (HbsAg) positivity also associated with recurrence in HBV-related HCC.
  • A nomogram integrating recipient HBcAb, donor HBsAg, AFP, and Milan criteria demonstrated strong prognostic capacity.

Conclusions:

  • Recipient HBcAb is a significant predictor of post-transplant HCC recurrence.
  • The developed nomogram effectively predicts recurrence risk, potentially expanding eligibility for liver transplantation in HCC patients.
Abstract

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