Session Name: Liver: Hepatocellular Carcinoma and Other Malignancies
Session Date & Time: None. Available on demand.
*Purpose: The purpose of this study is to examine effects of TIPS placement on response to locoregional therapy (LRT) and clinical outcomes after liver transplantation in HCC patients.
*Methods: Adults who had TIPS placed prior to HCC diagnosis who underwent LT for HCC at a single center from 2014-2020 were included. Presence of TIPS and LRT response were collected from chart review of multi-phase cross-sectional abdominal imaging prior to LT, and tumor characteristics were collected via explant pathology. Clinical outcomes were assessed. Covariates of interest included age, sex, etiology of HCC, body mass index, MELD-Na after LRT, timing from TIPS to LRT, number of LRT treatments, and timing from HCC diagnosis to LT.
*Results: Of 303 patients who underwent LT for HCC at a single center from 2014-2020 and met eligibility for the study, 13 (4.3%) had TIPS placed prior to diagnosis of HCC, and 1 (0.03%) had TIPS placed while undergoing LRT but prior to LT. Of the 13 patients with TIPS prior to HCC diagnosis, the mean age at HCC diagnosis was 60.4 years, and the sample was 92.3% male (12 of 13). 10 (76.9%) patient received at least one LRT prior to LT, and 5 (38.5%) underwent 2 or more LRTs. Post-LT survival among patients with TIPS was excellent, with 100% survival rate and no HCC recurrence on follow up imaging. Zero TIPS patients displayed post-LT hepatic vasculature complications within 1 year of LT. Calculated RETREAT scores ranged from 0 to 2, with the most common score being 1 (76.9% [n = 10]). Overall post-transplant HCC-free survival and post-transplant complication rates were superior to overall HCC transplant data at the center (100% 3-yr survival with a functioning graft vs 87.34% expected 3-yr survival with a functioning graft unadjusted for patient and donor characteristics).
*Conclusions: Presence of TIPS does not appear to increase post-LT complications, nor does TIPS affect HCC recurrence and recurrent-free survival. Overall post-transplant HCC-free survival and low post-transplant complication rates may be attributable to tumor biological behavior, low AFP, and low RETREAT scores among HCC patients with TIPS.
To cite this abstract in AMA style:Hanlon CL, Toy D, Liu Y, Zhou S, Zhou K, Kahn J, Yuan L. Effects of TIPS on Transplant Outcomes for HCC [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/effects-of-tips-on-transplant-outcomes-for-hcc/. Accessed September 21, 2021.
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