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Predictive Value of Alpha-fetoprotein in the Survival of Living Donor Liver Transplantation Recipients for Hepatocellular Carcinoma.

BACKGROUND/AIMS
Preoperative alpha-fetoprotein (AFP) level seems to be correlated with the outcomes of hepatocellular carcinoma (HCC). This study aimed to evaluate the predictive value of AFP in living donor liver transplantation (LDLT) recipients who met different selection criteria for HCC.


METHODOLOGY
We used a database of LDLT performed at our institution for HCC between January 2001 and January 2012, and evaluate the influence of AFP (400 ng/mL) on posttransplant survival among different criteria: group M (within Milan criteria), group U (exceeding Milan but within UCSF criteria) and group E (exceeding UCSF criteria).


RESULTS
The mean follow-up was 38.9 ± 26.4 months. In group M and U, the 1-, 3- and 5-year overall and tumor-free survival rates were similar between those with AFP level of < 400 and of ≥ 400 ng/mL. In group E, the 1-, 3- and 5-year overall and tumor-free survival rate were significantly higher in those with AFP of < 400 ng/mL than that in those with AFP of 400 ng/mL.


CONCLUSIONS
Preoperative AFP could not contribute to predicting the survival of patients who meet Milan and UCSF criteria, inversely, the survival is improved by taking into account preoperative AFP when tumors exceed UCSF criteria.