Elevation of CA-125 level is due to abdominal distension in liver transplantation candidates

Background CA (cancer antigen) 125 is a serologic marker used in the monito ring of ovarian cancer. Elevated levels are also reported in cirrhosis. We evaluated the range of serum CA 125 levels seen before and after liver tran splantation, and examined possible factors associated with CA 125 elevation . Methods. We examined prospectively 57 consecutive patients with cirrhosis w ho underwent liver transplantation. CA 125 levels were also measured in two patients with polycystic liver disease. Results. The mean serum CA 125 level before transplantation was 352 +/- 549 u/ml, compared with 46 +/- 49 u/ml after transplantation (P <0.001). Multi variate analysis identified the degree of ascites as the only significant p redictive variable of preoperative CA 125 level. In five patients who under went abdominal paracentesis, the mean ascites CA 125 level (951 +/- 322 u/m l) was higher than that of the serum (619 +/- 290 u/ml) (P <0.003). In 16 h epatectomy specimens, the grade of staining for CA 125 was 0.8 +/-1.4 for t he mesothelium of patients with a normal serum CA 125 level, compared with 1.5 +/-1.1 in patients with elevated serum levels (P=0.37). Two patients wi th severe abdominal distension due to polycystic liver disease but without ascites had elevated serum CA 125 levels. Discussion. CA 125 concentration is elevated in the majority of patients wi th cirrhosis and normalizes after liver transplantation. It is a reflection of the abdominal distention seen in these patients. Therefore, an elevatio n in CA 125 should not be considered a contraindication to liver transplant ation in the absence of evidence of malignancy.