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Role of Circulating Tumour Cells in the Management of the Liver Transplant Patient with Hepatocellular Carcinoma

F. Villalba1, F. Alconchel2, L. Sáenz3, M. Sánchez-Lorencio1, D. Ferreras2, P. Cascales2, F. Sánchez-Bueno2, R. Robles2, P. Ramírez2

1IMIB-Virgen de la Arrixaca, Murcia, Spain, 2Surgery and Organ Transplantation, Virgen de la Arrixaca University Hospital (IMIB-Virgen de la Arrixaca), Murcia, Spain, 3Rafael Méndez Hospital, Lorca, Spain

Meeting: 2022 American Transplant Congress

Abstract number: 38

Keywords: Biopsy, Hepatocellular carcinoma, Liver transplantation, Surgery

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: 4:30pm-4:40pm

Location: Hynes Room 312

*Purpose: For hepatocellular carcinoma (HCC), liver transplantation (LT) is considered a curative treatment, however, more than 10% of transplant recipients have recurrences within the first year. This suggests the existence of circulating-tumor-cells (CTC) that spread from a primary tumor and travel to peripheral blood and distant organs. Their detection and monitoring could be of great clinical value to an early prediction of recurrence as a real-time liquid biopsy. The aim of this study is to determine the relationship between CTC and clinicopathological variables and to compare the CTC-levels in patients with HCC before transplantation and at one and two years after surgery.

*Methods: Peripheral blood was obtained from 34 patients with HCC included in the LT list. Immunomagnetic isolation of CTC was performed by the IsoFlux® System. Cell enrichment was stained with anti-CK, Hoechst-33342 and antiCD45, performing cell counting under a fluorescence microscope. The clinicopathological variables (number of tumors, vascular invasion, tumor necrosis and recurrence) were collected. Spearman’s rho, Mann-Whitney and Wilcoxon test were used.

*Results: We found statistically significant differences in the CTC-levels between patients with vascular invasion and those without (U=0; p=0.005) such that patients with vascular invasion had median levels of 539 CTC/10 mL (IR: 448-1768) and those without vascular invasion had median levels of 3 CTC/10 mL (IR:0-31.25). Also we found a statistically significant decrease in post-transplant CTC-values at one year (Z= -2.672/ p=0.008) and two years (Z= -2.218/ p=0.027).

*Conclusions: The median CTC-levels of the patients included in the study showed a downward trend after liver transplantation. Also, a significant difference was found in the levels of pre-transplant-CTC between patients with and without vascular invasion, these levels being significantly higher in patients with vascular invasion compared to those without vascular invasion. Detection of CTC may have a useful clinical implication in predicting the evolution of HCC after LT.

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To cite this abstract in AMA style:

Villalba F, Alconchel F, Sáenz L, Sánchez-Lorencio M, Ferreras D, Cascales P, Sánchez-Bueno F, Robles R, Ramírez P. Role of Circulating Tumour Cells in the Management of the Liver Transplant Patient with Hepatocellular Carcinoma [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/role-of-circulating-tumour-cells-in-the-management-of-the-liver-transplant-patient-with-hepatocellular-carcinoma/. Accessed May 8, 2025.

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