Liver transplant for hepatocellular carcinoma in metabolic dysfunction-associated steatotic liver disease versus other etiologies: A meta-analysis

Parente, Alessandro; Milana, Flavio; Hajibandeh, Shahin; Hajibandeh, Shahab; Menon, Krishna V.; Kim, Ki-Hun; Shapiro, A. M. James; Schlegel, Andrea

Abstract

Background & Aims
Liver transplantation for hepatocellular carcinoma (HCC) in metabolic dysfunction-associated steatotic liver disease (MASLD) is increasingly being diagnosed and predicted to rise further. We compared outcomes of transplantation for MASLD-related HCC versus other etiologies (OE).

Methods
Databases were searched to identify studies comparing outcomes after transplantation MASLD-related HCC with OE-related HCC. Study data were pooled using random-effects modelling. Survival outcomes were analyzed using hazard ratio (HR) for overall survival (OS) and odds ratio (OR) for 1-,3-, and 5-years OS and disease-free survival (DFS).

Results
Ten retrospective comparative studies were identified including a total number of 51′761 patients (MASLD-related HCC=6′793, OE-related HCC=44′968). There were no significant differences in time-to-even survival (HR:0.93, CI95 % 0.81–1.07,p = 0.29), 1-year (87.6% vs 88 %;OR:1.15; CI95 %0.73–1.79,p = 0.55), 3-year (77.2% vs 76 %;OR:1.36;CI95 %0.96–1.94,p = 0.08), or 5-year (67.7% vs 66.3 %;OR:1.08; CI95 %0.77–1.53,p = 0.65) OS rates between the groups. DFS was comparable at 1-year (87.9% vs. 87 %; OR:1.07,p = 0.62), 3-years (77.6% vs. 73.6 %;OR:1.66,p = 0.13) and 5-year (68% vs. 65.6 %;OR:1.37,p = 0.39).

Conclusion
This meta-analysis of the best available evidence (Level 2a) demonstrated that liver transplantation for MASLD-related and OE-related HCC has comparable survival outcomes. Given the global rise in MASLD-related HCC as indication for transplantation, larger studies from other continents, including Europe and Asia, are needed to confirm our findings.

Citation

Parente, A., Milana, F., Hajibandeh, S., Hajibandeh, S., Menon, K. V., Kim, K.-H., Shapiro, A. M. J., & Schlegel, A. (2024). Liver transplant for hepatocellular carcinoma in metabolic dysfunction-associated steatotic liver disease versus other etiologies: A meta-analysis. Digestive and Liver Disease, https://doi.org/10.1016/j.dld.2024.09.025

• Journal Article Type: Article
• Acceptance Date: Sep 26, 2024
• Online Publication Date: Oct 29, 2024
• Publication Date: Oct 29, 2024
• Deposit Date: Dec 12, 2024
• Journal: Digestive and Liver Disease
• Print ISSN: 1590-8658
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1016/j.dld.2024.09.025
• Public URL: https://keele-repository.worktribe.com/output/972036
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S1590865824010442?via%3Dihub