Clinical significance of pulmonary nodules in the pretransplant evaluation of liver transplant recipients with hepatocellular carcinoma

• Published in: Experimental and clinical transplantation Vol. 16; no. 3; pp. 314 - 320
• Main Authors: Serrano,Oscar K, Olgun,Deniz C, Goduguchinta,Varshita, Bangdiwala,Ananta, Odegard,Marjorie N, Kandaswamy,Raja, Matas,Arthur J, Lake,John R, Pruett,Timothy L, Chinnakotla,Srinath
• Format: Journal Article
• Language: English
• Published: Başkent Üniversitesi 01-06-2018
• Subjects: Tıp; Ankara; Türkiye; Radiologic assessment; Transplant evaluation; Extrahepatic cancer; Metastases
• ISSN: 1304-0855; 2146-8427
• DOI: 10.6002/ect.2017.0227

Objectives: Pulmonary nodules are common in patients
with hepatocellular carcinoma who are being
evaluated for a possible liver transplant.
Materials and Methods: In this retrospective study, we
analyzed the records of liver transplant recipients at
our institution with a primary diagnosis of hepa -
tocellular carcinoma who received transplants
between 2000 and 2015. All patients had magnetic
resonance imaging-confirmed disease within Milan
criteria and a concurrent staging chest computed
tomography. Patient survival was estimated using
Kaplan-Meier methods and compared between
pulmonary nodule characteristic groups. A Cox
proportional hazards model was constructed for
adjusted analysis.
Results: Of the 197 liver transplant recipients who met
our study inclusion criteria (median follow-up, 40 mo),
115 (58.4%) had a total of 231 pulmonary nodules,
with 57 (49.6%) having multiple nodules and
108 (93.9%) having nodules < 1 cm. The presence of
pulmonary nodules did not negatively affect patient
survival, per our univariate and multivariate analysis,
nor did their presence affect their number, location,
laterality, shape, edge, density, or the presence of
calcifications (P > .05). However, pulmonary nodules
> 1 cm were associated with decreased overall
survival.
Conclusions: In our pretransplant evaluation of
patients with hepatocellular carcinoma, pulmonary
nodules < 1 cm did not portend worse patient or graft survival posttransplant.