Prognostic implication of early posttransplant hypercholesterolemia in liver transplantation for patients with hepatocellular carcinoma  

作　　者：Rong-Li Wei Guang-Han Fan Chen-Zhi Zhang Kang-Chen Chen Wen-Hui Zhang Chang-Biao Li Si-Yi Dong Jun-Li Chen Sun-Bin Ling Shu-Sen Zheng Xiao Xu 

机构地区：[1]Department of Hepatobiliary and Pancreatic Surgery,The Center for Integrated Oncology and Precision Medicine,Affiliated Hangzhou First People’s Hospital,Zhejiang University School of Medicine,Hangzhou 310006,China [2]Department of Hepatobiliary and Pancreatic Surgery,The First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310003,China [3]Institute of Organ Transplantation,Zhejiang University,Hangzhou 310003,China [4]National Center for Healthcare Quality Management in Liver Transplant,Hangzhou 310003,China [5]Department of Hepatobiliary and Pancreatic Surgery,Shulan(Hangzhou)Hospital,Hangzhou 310022,China

出　　处：《Hepatobiliary & Pancreatic Diseases International》2023年第3期228-238,共11页国际肝胆胰疾病杂志（英文版）

基　　金：supported by grants from the National Natural Science Funds for Distinguished Young Scholars of China (81625003);the Key Program,National Natural Science Foundation of China (81930016);the Key Research&Development Plan of Zhejiang Province (2019C03050)。

摘　　要：Background: Hyperlipidemia is a common complication after liver transplantation(LT) and develops mostly in the early posttransplant period. Recently, some studies have reported a positive correlation between hyperlipidemia and favorable prognosis in patients with hepatocellular carcinoma(HCC) undergoing hepatectomy. This study aimed to evaluate the possibility of predicting prognosis in HCC patients receiving LT by early posttransplant dyslipidemia. Methods: From January 2015 to December 2017, a total of 806 HCC patients from China Liver Transplant Registry database were retrospectively enrolled. The prognostic relevance of early posttransplant hypertriglyceridemia or hypercholesterolemia was examined using survival analysis, and subgroup analysis was implemented based on LT criteria. Results: Early posttransplant hypercholesterolemia(EPHC) was independently inversely associated with the risk of recurrence [hazard ratio(HR) = 0.630;P = 0.022], but was not significantly correlated with the mortality. However, early posttransplant hypertriglyceridemia was not related to prognosis. Intriguingly, with further classification, we found that borderline EPHC(B-EPHC), instead of significant EPHC, was a predictor of lower risk for both recurrence(HR = 0.504;P = 0.006) and mortality(HR = 0.511;P = 0.023). Compared with non-EPHC patients, B-EPHC patients achieved significantly superior 1-year and 3-year tumor-free survival(89.6% and 83.7% vs. 83.8% and 72.7% respectively;P = 0.023), and 1-year and 3-year overall survival(95.8% and 84.8% vs. 94.6% and 77.6% respectively;P = 0.039). In the subgroup analysis, BEPHC remained an independent predictor of better prognosis in patients beyond Milan criteria and those within Hangzhou criteria;whereas there was no significant relationship between B-EPHC and prognosis in patients within Milan criteria and those beyond Hangzhou criteria. More interestingly, patients beyond Milan criteria but within Hangzhou criteria were identified as the crucial subpopulation who benefited from B-EPHC(r

关 键 词：Liver transplantation Hepatocellular carcinoma HYPERCHOLESTEROLEMIA PROGNOSIS 

分 类 号：R735.7[医药卫生—肿瘤]