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Performance of pre-transplant criteria in prediction of hepatocellular carcinoma progression and waitlist dropout

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dc.contributor.authorPiñero, Federico
dc.contributor.authorThompson, Marcos
dc.contributor.authorBoin, Ilka
dc.contributor.authorChagas, Aline
dc.contributor.authorQuiñonez, Emilio
dc.contributor.authorBermúdez, Carla
dc.contributor.authorVilatobá, Mario
dc.contributor.authorSantos, Luisa
dc.contributor.authorAnders, Margarita
dc.contributor.authorHoyos , Sergio
dc.contributor.authorSoares, Agnaldo
dc.contributor.authorMenendez, Josemaría
dc.contributor.authorPadilla, Martín
dc.contributor.authorPoniachik, Jaime
dc.contributor.authorZapata, Rodrigo
dc.contributor.authorMaraschio, Martín
dc.contributor.authorChong, Ricardo
dc.contributor.authorMuñoz, Linda
dc.contributor.authorArufe, Diego
dc.contributor.authorFigueroa, Rodrigo
dc.contributor.authorPerales, Simone
dc.contributor.authorMaccali, Claudia
dc.contributor.authorVergara, Rodrigo
dc.contributor.authorMcCormack, Lucas
dc.contributor.authorVarón, Adriana
dc.contributor.authorMarciano, Sebastián
dc.contributor.authorMattera, Juan
dc.contributor.authorCarrilho, Flair
dc.contributor.authorSilva, Marcelo
dc.date.accessioned2023-04-27T13:36:17Z
dc.date.available2023-04-27T13:36:17Z
dc.date.issued2022
dc.description.abstractBackground & aim: Liver transplantation (LT) selection models for hepatocellular carcinoma (HCC) have not been proposed to predict waitlist dropout because of tumour progression. The aim of this study was to compare the alpha-foetoprotein (AFP) model and other pre-LT models in their prediction of HCC dropout. Methods: A multicentre cohort study was conducted in 20 Latin American transplant centres, including 994 listed patients for LT with HCC from 2012 to 2018. Longitudinal tumour characteristics, and patterns of progression were recorded at time of listing, after treatments and at last follow-up over the waitlist period. Competing risk regression models were performed, and model's discrimination was compared estimating Harrell's adapted c-statistics. Results: HCC dropout rate was significantly higher in patients beyond (24% [95% CI 16-28]) compared to those within Milan criteria (8% [95% IC 5%-12%]; p < .0001), with a SHR of 3.01 [95% CI 2.03-4.47]), adjusted for waiting list time and bridging therapies (c-index 0.63 [95% CI 0.57; 0.69). HCC dropout rates were higher in patients with AFP scores >2 (adjusted SHR of 3.17 [CI 2.13-4.71]), c-index of 0.71 (95% CI 0.65-0.77; p = .09 vs Milan). Similar discrimination power for HCC dropout was observed between the AFP score and the Metroticket 2.0 model. In patients within Milan, an AFP score >2 points discriminated two populations with a higher risk of HCC dropout (SHR 1.68 [95% CI 1.08-2.61]). Conclusions: Pre-transplant selection models similarly predicted HCC dropout. However, the AFP model can discriminate a higher risk of dropout among patients within Milan criteria.
dc.description.versionVersión Publicada
dc.identifier.citationPiñero F, Thompson M, Boin I, Chagas A, Quiñonez E, Bermúdez C, Vilatobá M, Santos L, Anders M, Hoyos Duque S, Soares Lima A, Menendez J, Padilla M, Poniachik J, Zapata R, Maraschio M, Chong Menéndez R, Muñoz L, Arufe D, Figueroa R, Perales SR, Maccali C, Vergara Sandoval R, McCormack L, Varón A, Marciano S, Mattera J, Carrilho F, Silva M. Performance of pre-transplant criteria in prediction of hepatocellular carcinoma progression and waitlist dropout. Liver Int. 2022 Aug;42(8):1879-1890. doi: 10.1111/liv.15223
dc.identifier.doihttps://doi.org/10.1111/liv.15223
dc.identifier.urihttps://repositorio.udd.cl/handle/11447/7413
dc.language.isoen
dc.subjectDelisting
dc.subjectLiver
dc.subjectOutcomes
dc.subjectRadiological progression
dc.titlePerformance of pre-transplant criteria in prediction of hepatocellular carcinoma progression and waitlist dropout
dc.typeArticle
dcterms.accessRightsAcceso abierto
dcterms.sourceLiver international : official journal of the International Association for the Study of the Liver
dspace.entity.typePublication

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