ArticleScientific reports2025
Prothrombin-induced by vitamin K absence II as a prognostic factor in living donor liver transplantation for hepatocellular carcinoma.
Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Review Article: Biomarkers in Liver Transplantation for Hepatocellular Carcinoma: Towards Precision Medicine.Alimentary pharmacology & therapeutics · 2026Review
- Baseline DCP May Modify Response to Atezolizumab-Bevacizumab Versus Durvalumab-Tremelimumab in Unresectable HCC.Liver international : official journal of the International Association for the Study of the Liver · 2026Article
- Identifying a biologically high-risk subgroup of anatomically resectable hepatocellular carcinoma.Hepatology international · 2026Article
- Serum protein induced by vitamin K absence or antagonist-II predicts aggressive tumor biology in alpha-fetoprotein-normal hepatocellular carcinoma.World journal of gastrointestinal oncology · 2026Article
- Gamma-Glutamyl Transferase Improves Biological Risk Stratification in Living Donor Liver Transplantation for Hepatocellular Carcinoma.Journal of gastrointestinal cancer · 2026Article
- Log-transformed α-Fetoprotein andIn vivo (Athens, Greece)Article
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8 authors.
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Abstract
In hepatocellular carcinoma (HCC), there is a need for novel tumor markers to enhance patient selection for liver transplantation. This study evaluates the prognostic value of Prothrombin Induced by Vitamin K Absence-II (PIVKA-II) in predicting microvascular invasion (MVI) and post-transplant recurrence, either alone or in combination with alpha-fetoprotein (AFP), following living donor liver transplantation (LDLT). We reviewed 400 patients who underwent LDLT under expanded criteria (largest tumor diameter ≤ 10 cm, any tumor number, AFP < 1000 ng/ml). PIVKAII outperformed AFP and tumor size in predicting MVI, with a C-statistic of 0.777 compared to 0.579 and 0.631. On multivariate analysis, AFP > 20 ng/ml [HR 3.3, P = 0.003] and PIVKAII > 1000 mAU/ml [HR 3.5, P = 0.001] were predictors of recurrence. PIVKAII > 1000 mAU/ml was associated with MVI (21.6% vs. 65.7%, P < 0.001) and lower 5-year RFS (79% vs. 50%, P < 0.001). A combination of AFP > 20 ng/ml and PIVKAII > 1000 mAU/ml predicted 47.1% of recurrences, whereas HCC recurred in 6.1% of patients not meeting this threshold. The 5-year RFS was 45% for dual tumor marker positive HCC versus 77% for all others (P < 0.001). PIVKAII is a strong predictor of MVI and post-transplant recurrence. Dual tumor marker-positive HCC can serve as an exclusion criterion for upfront LDLT.
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