A changing etiologic scenario in liver transplantation for hepatocellular carcinoma in a multicenter cohort study from Latin America
| Autor: | Rodrigo Zapata, Josemaría Menéndez, Luis G. Podesta, Marcelo Silva, Federico Piñero, Jaime Poniachik, Martín Maraschio, Yuri L. Boteon, Sebastián Marciano, Paulo Henrique Alves da Costa, Sergio Iván Hoyos Duque, Mario Vilatobá, Parente García, Ilka S. F. Fatima Boin, Adriana Varón, Margarita Anders, Adrián Gadano, Linda Muñoz, Alejandro Soza, Alina Zerega, Lucas McCormack, Martín Padilla Machaca |
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| Rok vydání: | 2017 |
| Předmět: |
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Alcoholic liver disease medicine.medical_specialty Carcinoma Hepatocellular medicine.medical_treatment Liver transplantation Gastroenterology Cohort Studies 03 medical and health sciences Liver disease 0302 clinical medicine Internal medicine medicine Humans Prospective cohort study Hepatology business.industry Fatty liver Liver Neoplasms Middle Aged medicine.disease digestive system diseases Liver Transplantation Latin America 030220 oncology & carcinogenesis Hepatocellular carcinoma Cohort 030211 gastroenterology & hepatology Female business Cohort study |
| Zdroj: | Clinics and research in hepatology and gastroenterology. 42(5) |
| ISSN: | 2210-741X |
| Popis: | Summary Background and aim Non-alcoholic fatty liver disease (NAFLD) is an increasing cause of hepatocellular carcinoma (HCC) and liver transplantation (LT). Our study focused on changing trends of liver related HCC etiologies during the last years in Latin America. Methods From a cohort of 2761 consecutive adult LT patients between 2005 and 2012 in 17 different centers, 435 with HCC were included. Different periods including years 2005–2006, 2007–2008, 2009–2010 and 2011–2012 were considered. Etiology of liver disease was confirmed in the explant. Results Participating LT centers per country included 2 from Brazil (n = 191), 5 transplant programs from Argentina (n = 98), 2 from Colombia (n = 65), 4 from Chile (n = 49), 2 from Mexico (n = 12), and 1 from Peru (n = 11) and Uruguay (n = 9). Chronic hepatitis C infection was the leading cause of HCC in the overall cohort (37%), followed by HBV (25%) and alcoholic liver disease (17%). NAFLD and cryptogenic cirrhosis accounted for 6% and 7%, respectively. While HCV decreased from 48% in 2005–06 to 26% in 2011–12, NAFLD increased from 1.8% to 12.8% during the same period, accounting for the third cause of HCC. This represented a 6-fold increase in NAFLD-HCC, whereas HCV had a 2-fold decrease. Patients with NAFLD were older, had lower pre-LT serum AFP values and similar 5-year survival and recurrence rates than non-NAFLD. Conclusion There might be a global changing figure regarding etiologies of HCC in Latin America. This epidemiological change on the incidence of HCC in the world, although it has been reported, should still be confirmed in prospective studies. |
| Databáze: | OpenAIRE |
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