Anti-Alpha fetoprotein polyclonal antibody

Purpose The role of preoperative locoregional therapy (LRT) for hepatocellular carcinoma (HCC) before liver transplantation (LT) remains unclear. Moreover, LRT in the setting of living donor liver transplantation (LDLT) merits further exploration. The objective of the current study was to determine risk factors for poor outcomes after LDLT in patients who received locoregional therapy (LRT). Methods We reviewed patients (n = 46) who underwent LDLT after LRT. Multivariate analysis was performed to determine independent predictors of recurrence-free survival (RFS). Risk scores were developed to define prognostic groups. Results Median tumor size was 3.7 (1.2-12) cm and tumor number was 1 (1-6). Macrovascular invasion was seen in 10/46 (21.7%) patients. There was a significant difference in 5-year RFS with > 3 tumor nodules (P = 0.005), tumors outside University of California San Francisco criteria (P = 0.03), bilobar disease (P = 0.002), AFP > 600 ng/ml (P = 0.006), and poor response to LRT (P = 0.007). On multivariate analysis, bilobar disease (HR = 2.9, P = 0.01), AFP > 600 ng/ml (HR = 2.3 P = 0.008), and poor response to LRT (HR = 2, P = 0.02) were predictors of 5-year RFS. The 5-year RFS in low risk (score = 0), intermediate risk (score = 1-3), and high risk (score = 4-7) groups was 86%, 76%, and 9% (P < 0.0001). There was no recurrence seen in 4/4 (100%) patients with macrovascular invasion in the low-intermediate risk group. The 5-year RFS in the low-intermediate risk group within and outside Milan criteria was 100% and 74% (P = 0.1). Conclusions LDLT can provide excellent long-term RFS in patients after preoperative LRT in the low and intermediate risk groups.

Entecavir (ETV) and tenofovir (TDF) are both potent antiviral agents for the treatment of chronic hepatitis B virus (HBV) infection. The primary effective endpoints of treatment have been a sustained disappearance of HBV DNA and hepatitis B e-antigen (HBeAg) loss or seroconversion. We compared the efficacy of ETV and TDF and determined clinical factors that contributed to HBeAg loss at Pao-Chien Hospital in Pingtung city. We conducted a retrospective study. A total of 36 consecutive patients with chronic hepatitis B (CHB) (e-positive) antigens were treated with ETV (n = 19) and TDF (n = 17) between January 2010 and January 2018. Demographic and baseline characteristics were used for Cox proportion hazard regression models to identify variables that were predictive of ETV and TDF-induced HBeAg loss. The alfa fetal protein (AFP) levels were higher in patients with HBeAg loss than in those without loss (P = .006). Of which, 17 (47.2%) of 36 patients achieved HBeAg loss and 12 (33.3%) patients achieved HBeAg seroconversion. None of these seroconversion patients developed serum reversion after consolidation therapy and off treatment. The cumulative rate of HBeAg loss at years 1, 2, and 3 of therapy was 22.2% (8/36), 37.0% (10/27), and 57.7% (15/26), respectively. In cumulative rate at years 1 and 2, the frequency of HBeAg loss was observed greater in virological response at 6 months (13.9% vs 8.3%, P = .013; 40% vs 22%, P = .028, respectively). In multivariate Cox regression analysis for factors associated with HBeAg loss, an increase in virological response at 6 months (adjusted hazard ratio [HR] = 4.780; 95% CI, 1.013-22.565; P = .048) was only significant factor associated with cumulative HBeAg loss rate at year 2 (adjusted HR = 0.183; 95% CI, 0.043-0.774; P = .021). The rapidity and efficacy of HBV DNA reduction to undetectable is the predictor of nucleos(t)ide analogue (NUC)-induced HBeAg loss. Early undetectable HBV DNA in 6 months might be used to predict a higher likelihood of HBeAg loss within 2-year therapy with NUC.