INVESTIGADORES
MARCIANO Sebastian
artículos
Título:
A changing etiologic scenario in liver transplantation for hepatocellular carcinoma in a multicenter cohort study from Latin America
Autor/es:
PIÑERO, FEDERICO; COSTA, PAULO; BOTEON, YURI LONGATTO; DUQUE, SERGIO HOYOS; MARCIANO, SEBASTIAN; ANDERS, MARGARITA; VARÓN, ADRIANA; ZEREGA, ALINA; PONIACHIK, JAIME; SOZA, ALEJANDRO; MCCORMACK, LUCAS; GADANO, ADRIAN; SILVA, MARCELO
Revista:
Clinics and Research in Hepatology and Gastroenterology
Editorial:
Elselvier
Referencias:
Año: 2018 vol. 42 p. 443 - 452
ISSN:
2210-7401
Resumen:
Background and aim: Non-alcoholic fatty liver disease (NAFLD) is an increasing cause of hepatocellular carcinoma (HCC) and liver transplantation (LT). Our study focused on changing trendsof liver related HCC etiologies during the last years in Latin America.Methods: From a cohort of 2761 consecutive adult LT patients between 2005 and 2012 in 17different centers, 435 with HCC were included. Different periods including years 2005?2006,2007?2008, 2009?2010 and 2011?2012 were considered. Etiology of liver disease was confirmedin the explant.Results: Participating LT centers per country included 2 from Brazil (n = 191), 5 transplant programs from Argentina (n = 98), 2 from Colombia (n = 65), 4 from Chile (n = 49), 2 from Mexico(n = 12), and 1 from Peru (n = 11) and Uruguay (n = 9). Chronic hepatitis C infection was theleading cause of HCC in the overall cohort (37%), followed by HBV (25%) and alcoholic liver disease (17%). NAFLD and cryptogenic cirrhosis accounted for 6% and 7%, respectively. While HCVdecreased from 48% in 2005?06 to 26% in 2011?12, NAFLD increased from 1.8% to 12.8% duringthe same period, accounting for the third cause of HCC. This represented a 6-fold increase inNAFLD-HCC, whereas HCV had a 2-fold decrease. Patients with NAFLD were older, had lowerpre-LT serum AFP values and similar 5-year survival and recurrence rates than non-NAFLD.Conclusion: There might be a global changing figure regarding etiologies of HCC in Latin America. This epidemiological change on the incidence of HCC in the world, although it has beenreported, should still be confirmed in prospective studies
