G Harsha Vardhan, Reddy and Venkata Sai Praneeth, Muduru and Gaddam Yaswanth, Kumar and Chinni, Anupama and Ananya Reddy, Vangala (2025) A Meta-Analysis of Hepatocellular Carcinoma Recurrence Following Liver Transplantation: Influence of Tumor Etiology and Alpha-Fetoprotein Levels. BMC Medical Education, 25. pp. 400-409.

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Abstract

Background: Hepatocellular carcinoma (HCC) is a major indication for liver transplantation (LT). However, recurrence of HCC post-transplantation continues to compromise long-term outcomes. Risk of recurrence may be influenced by the underlying liver disease and preoperative biomarkers, particularly alpha-fetoprotein (AFP). This meta-analysis aims to evaluate recurrence rates following LT and investigate the association of recurrence with HCC etiology and AFP levels. Methods: A systematic review was conducted using PubMed, Embase, and the Cochrane Library for studies published between January 2000 and March 2025. Studies were included if they reported post-LT recurrence of HCC stratified by etiology (HBV, HCV, NASH, ALD) and/or pretransplant AFP levels. Pooled recurrence rates and odds ratios (ORs) were calculated using a random-effects model. Heterogeneity was assessed using the I² statistic. Results: A total of 47 studies involving 28,953 patients were included. The overall pooled recurrence rate of HCC following LT was 13.4% (95% CI: 11.6–15.3%). Recurrence was highest in patients with HCV-related HCC (16.2%), followed by those with NASH (14.1%), ALD (12.8%), and HBV (10.2%). In a subgroup analysis of 26 studies reporting AFP levels, patients with AFP >400 ng/mL had a significantly increased recurrence risk compared to those with AFP ?400 ng/mL (23.3% vs. 8.1%; OR: 3.82, 95% CI: 2.91–5.01, p < 0.001). Moderate heterogeneity was observed across studies (I² = 52%). Conclusion: HCC recurrence following LT varies with underlying etiology and is significantly associated with elevated pretransplant AFP levels. These variables should be incorporated into transplant selection protocols and individualized surveillance strategies to optimize post-transplant outcomes.

Item Type:	Article
Subjects:	R Medicine > R Medicine (General)
Divisions:	Postgraduate > Master's of Islamic Education
Depositing User:	Journal Editor
Date Deposited:	06 Aug 2025 10:18
Last Modified:	06 Aug 2025 10:18
URI:	http://eprints.umsida.ac.id/id/eprint/16308

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