ArticleWorld journal of transplantation2025
Association of vascular invasion and tumor differentiation on post-liver transplant outcomes in patients with hepatocellular carcinoma.
Article in World journal of transplantation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Multifaceted role of histopathology in liver transplantation for hepatocellular carcinoma: A narrative review towards precision prognosis.World journal of transplantation · 2026Article
- Systemic Treatment for Hepatocellular Carcinoma Recurrence After Liver Transplantation.Current oncology (Toronto, Ont.) · 2026Review
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10 authors.
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Abstract
backgroundLiver transplant (LT) is one of the main treatment options in selected patients with hepatocellular carcinoma (HCC). Overall, macrovascular invasion has been shown to be associated with an increased risk of tumor recurrence and mortality after LT in HCC. Macrovascular invasion detected on imaging is often considered a contraindication for LT in HCC.
aimTo investigate the effect of macrovascular invasion in explant on post-LT survival in HCC patients using a large national transplant database in the United States.
methodsLT recipients with HCC between the years 2012 and 2022 were identified by using the United Network for Organ Sharing/Organ Procurement Transplant Network database. Patients who underwent deceased-donor LT with available liver explant pathology data were included. Kaplan-Meier curves were used for survival analysis, and multistep regression analysis was used to determine the predictors of mortality.
resultsA total of 13638 LT recipients with HCC and available explant pathology were included. Of these, 254 (1.8%) showed macrovascular invasion, 1712 (12.6%) had microvascular invasion, and 11672 (85.6%) had absent invasion. Poor tumor differentiation was more common with macrovascular invasion than with microvascular or absent invasion (22.4%, 17.7%, and 5.1%, respectively,
conclusionMacrovascular invasion accounted for a minority of cases at 1.8%. Macrovascular invasion and poor tumor differentiation on liver explants in patients with HCC were associated with significantly higher post-LT mortality, meaning that the extent of tumor involvement and tumor biology are important predictors of post-LT survival in HCC. However, the overall 5-year survival in patients with macrovascular invasion may still be within an acceptable range.
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