Korean J Transplant.  2022 Nov;36(Supple 1):S36. 10.4285/ATW2022.F-1344.

Diagnostic role of tumor markers for hepatocellular carcinoma in liver transplantation candidates: an analysis using Korean Organ Transplantation Registry database

• Hwang S
• Kang WH
• Kim JM
• Lee KW
• Joo DJ
• You YK
• Ryu JH
• Kim BW
• Choi D
• Kim DS

• KMID: 2535208
• DOI: http://doi.org/10.4285/ATW2022.F-1344

Abstract

Background
This study intended to analyze pretransplant alpha-fetoprotein (AFP) and proteins induced by vitamin K absence or antagonist-II (PIVKA-II) in liver transplantation (LT) candidates.
Methods
A total of 3,273 LT recipients enrolled at the Korean Organ Transplantation Registry were divided according to hepato-cellular carcinoma (HCC) status and background liver disease, and AFP and PIVKA-II were compared.
Results
In all patients, the median AFP and PIVKA-II were 6.3 ng/mL and 29 mAU/mL in viable HCC group and 3.3 ng/mL and 35 mAU/mL respectively in no HCC group (P<0.001 for AFP and P=0.037 for PIVKA-II). In hepatitis B virus-associated patients, they were 6.0 ng/mL and 26 mAU/mL in HCC group and 3.2 ng/mL and 21 mAU/mL in no HCC group, respectively (P<0.001 and P<0.001). In hepatitis C virus-associated patients, they were 10.7 ng/mL and 37 mAU/mL in HCC group and 2.6 ng/mL and 21 mAU/mL in no HCC group, respectively (P<0.001 and P=0.117). In ALD patients, they were 5.2 ng/mL and 61 mAU/mL in HCC group and 6.4 ng/mL and 75 mAU/mL in no HCC group, respectively (P<0.001 and P=0.419). In patients with other diseases, they were 7.1 ng/mL and 32 mAU/mL in HCC group and 3.3 ng/mL and 28 mAU/mL in no HCC group, respectively (P<0.001 and P=0.822).
Conclusions
The results of the present study indicate that pretransplant serum AFP and PIVKA-II were highly variably expressed in LT candidates with end-stage liver diseases, thus their values should be cautiously interpreted because their role for HCC diagnosis is limited.