Degree of Pre-Liver Transplant Immune Dysfunction Correlates with Post-Transplant Cancer Recurrence

G. S. Prakash¹, G. G. Panayotova¹, S. Simonishvili¹, Y. Qin¹, L. Jin¹, T. Ayorinde¹, L. J. Minze², F. Paterno¹, L. Brown¹, A. Amin¹, D. Liu¹, R. Ghobrial², J. V. Guarrera¹, K. E. Lunsford¹

¹Rutgers New Jersey Medical School, Newark, NJ, ²Houston Methodist Hospital, Houston, TX

Meeting: 2022 American Transplant Congress

Abstract number: 32

Keywords: Hepatocellular carcinoma, Immune deviation, Malignancy, Tumor recurrence

Topic: Clinical Science » Liver » 56 - Liver: Hepatocellular Carcinoma and Other Malignancies

Session Information

Session Name: Hepatocellular Carcinoma and Other Malignancies

Session Type: Rapid Fire Oral Abstract

Date: Sunday, June 5, 2022

Session Time: 3:30pm-5:00pm

Presentation Time: 3:30pm-3:40pm

Location: Hynes Room 312

*Purpose: Despite stringent selection criteria for liver transplant (LT) in patients with liver-limited malignancy, post-transplant cancer recurrence remains problematic. We have previously identified a pre-LT biomarker panel, the Liver Immune Frailty Index (LIFI), which accurately stratifies patients into low, moderate, or high risk for early (<1 yr) post-LT mortality based on the degree of pre-LT immune dysfunction. As immune surveillance is crucial to tumor control, this study sought to determine whether pre-LT immune dysfunction correlates with recipient’s risk of cancer recurrence.

*Methods: Patients with pre-LT or explant diagnosis of malignancy were included. Multiplex cytokine analysis was performed on blood samples obtained immediately pre-LT. LIFI score, calculated based on serum HCV IgG, Eotaxin and Fractalkine levels, stratified pts as high-, medium- or low-LIFI. Cancer recurrence was correlated with pre-LT cytokine/chemokine levels and overall LIFI score. Median pt follow up was 54 months.

*Results: Plasma from 108 patients was analyzed (HCC, N=94; Cholangiocarcinoma/Mixed, N=14). On univariate analysis, elevated levels of pre-LT BAFF, MMP-3, IP-10, Fractalkine, CD27 and CD40 correlated with significantly increased risk of cancer recurrence post-LT. Multivariate analysis identified Fractalkine, a key component of the LIFI score, as the strongest pre-LT predictor of recurrence (HR=1.7, P=0.007). When stratified by LIFI, patients with LIFI-high had significantly elevated risk of cancer recurrence (HR 18.76, p<0.05), with a mean time to recurrence of six months following transplant, compared to a mean recurrence time of 26.9 months for LIFI-low.

*Conclusions: Pre-LT immune dysfunction significantly increases the risk of cancer recurrence post-LT. This preliminary analysis suggests the LIFI score, a pre-transplant calculated laboratory biomarker, correlates with early cancer recurrence. This may help assess and stratify patients with malignancy prior to liver transplant.

To cite this abstract in AMA style:

Prakash GS, Panayotova GG, Simonishvili S, Qin Y, Jin L, Ayorinde T, Minze LJ, Paterno F, Brown L, Amin A, Liu D, Ghobrial R, Guarrera JV, Lunsford KE. Degree of Pre-Liver Transplant Immune Dysfunction Correlates with Post-Transplant Cancer Recurrence [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/degree-of-pre-liver-transplant-immune-dysfunction-correlates-with-post-transplant-cancer-recurrence/. Accessed May 16, 2025.

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