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Table 1 Risk factors associated with HCC recurrence

From: Imaging of hepatocellular carcinoma recurrence after liver transplantation

Risk factors related to the tumor

Morphology

 Tumor burden: number and size of the nodules (Milan criteria, extended criteria)

 Presence of macrovascular invasion

 Presence of extrahepatic spread

Histology

 Poor tumor differentiation

 Microvascular invasion

 Genetic signature (CK19, etc.)

Serum markers

 Increased AFP serum level (Metrotickets 2.0 model, etc.)

 Increased DCP serum level

 Inflammatory markers (increased NLR; increased PLR)

Response to anticancer treatments (TACE, RE, TA, surgery)

Risk factors unrelated to the tumor

Characteristics of the recipient

 Older age

 Obesity

 Severity of underlying disease

 Immunological status

Liver graft

 Older age of the donor

 LDLT versus DDLT

 Steatosis

 Prolonged cold ischemia and ischemia–reperfusion injury

Immunosuppression after LT

 CNI (tacrolimus, cyclosporine)

 mTOR inhibitors (sirolimus and everolimus)

  1. AFP α-fetoprotein, DCP des‐γ-carboxy prothrombin, NLR neutrophil-to-lymphocyte ratio, PLR platelet-to-lymphocyte ratio, TACE transarterial chemoembolization, RE radioembolization, TA thermoablation, LDLT living donor liver transplantation, DDLT deceased donor liver transplantation, LT liver transplantation, CNI calcineurin inhibitors, mTOR inhibitors of the mammalian target of rapamycin