OUTCOME OF HEPATITIS-C PATIENTS WITH AND WITHOUT HEPATOCELLULAR-CARCINOMA UNDERGOING LIVER-TRANSPLANT

Objective: Hepatitis C virus (HCV) infection is associated with develo pment of hepatocellular carcinoma (HCC). The aim of this study was to examine clinical characteristics and outcome of patients with HCV with or without HCC undergoing liver transplant. Methods: We reviewed the charts of all 55 patients transplanted between November 1990 and Decem ber 1996 for HCV cirrhosis with HCC and compared them with a control g roup of HCV patients without HCC. Patients with a history of alcohol a buse or HBsAg positivity were excluded. There were 37 men and 18 women , with a mean age of 57.6 yr (range, 19-70 yr) in the HCC group. Resul ts: There was no significant difference between the HCC and nonHCC gro ups regarding Child's class or United Network for Organ Sharing (UNOS) status at the time of transplant. Twenty-six (45%) patients were diag nosed or suspected of having HCC before transplant. Twenty-five patien ts (45.5%) had a single focus of HCC. Fourteen percent (seven of 50) o f the patients with HCC had been treated with interferon, whereas 12% (six of 52) of patients in the nonHCC group had received interferon. D uration of interferon therapy ranged from 1 to 9 months. All interfero n treatment occurred within 5 yr of transplant. A history of intraveno us drug use or transfusion was identified in 37 (67%) of HCC patients. Thirty-two patients (58%) without HCC had a parenteral exposure. Ther e was no significant difference in patient or graft survival rates bet ween the patients with and without HCC. Conclusion: Approximately one- half of HCC was not detected before liver transplant. There was no sig nificant difference in the mode of transmission, clinical status at th e time of transplant, or outcome between the HCV patients with and wit hout HCC. (C) 1998 by Am. Cell. of Gastroenterology.