No Prognostic Impact of Graft-to-Recipient Weight Ratio on Hepatocellular Carcinoma Recurrence Following Living Donor Liver Transplantation

Geunhyeok Yang ¹, Shin Hwang ², Chul-Soo Ahn ²

⁰Department of Surgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University Graduate School, Seoul, South Korea.

Annals of Transplantation +

|

March 5, 2024

View abstract on PubMed

Summary

A low graft-to-recipient weight ratio (GRWR) did not impact hepatocellular carcinoma (HCC) recurrence after liver transplantation. This study found no significant difference in survival rates for HCC patients undergoing living donor liver transplantation (LDLT) with varying GRWRs.

Area Of Science

Hepatobiliary Surgery
Transplant Oncology
Gastroenterology

Background

The impact of graft-to-recipient weight ratio (GRWR) on outcomes for hepatocellular carcinoma (HCC) patients post-liver transplantation remains unclear.
Living donor liver transplantation (LDLT) is a common treatment for HCC, making GRWR a critical factor to evaluate.

Purpose Of The Study

To investigate the association between GRWR and tumor recurrence in patients with HCC undergoing LDLT.
To determine if a low GRWR (<0.8%) affects the prognosis of HCC patients post-LDLT.

Main Methods

Retrospective observational single-center study of 856 patients who underwent LDLT for HCC (January 2006 - December 2016).
Patients were categorized into four GRWR groups: <0.8%, 0.8-0.99%, 1.0-1.19%, and ≥1.2%.
Statistical analysis evaluated the correlation between GRWR and post-transplant tumor recurrence, disease-free survival (DFS), and overall survival (OS), including subgroup analyses based on Milan criteria and tumor markers.

Main Results

No significant differences in DFS (P=0.545) or OS (P=0.313) were observed across the four GRWR groups.
Subgroup analyses confirmed that GRWR did not influence survival rates for patients within or beyond the Milan criteria, or those with varying alpha-fetoprotein-des-γ-carboxyprothrombin-tumor volume scores.
Specifically, GRWR <0.8% showed no significant impact on oncological outcomes.

Conclusions

A GRWR below 0.8% does not appear to significantly affect the prognostic outcomes for patients with HCC following LDLT.
Further validation through high-volume, multi-center studies is recommended to confirm these findings regarding GRWR in LDLT for HCC.