Review
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 7, 2018; 24(37): 4230-4242
Published online Oct 7, 2018. doi: 10.3748/wjg.v24.i37.4230
New prognostic biomarkers of mortality in patients undergoing liver transplantation for hepatocellular carcinoma
Leonardo Lorente
Leonardo Lorente, Intensive Care Unit, Hospital Universitario de Canarias, Santa Cruz de Tenerife 38320, Spain
Author contributions: Lorente L drafted the manuscript.
Conflict-of-interest statement: The author has no financial or other conflicts of interest to declare related to the submitted manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Leonardo Lorente, MD, PhD, Attending Doctor, Medical Assistant, Intensive Care Unit, Hospital Universitario de Canarias, Ofra, s/n, Santa Cruz de Tenerife 38320, Spain. lorentemartin@msn.com
Telephone: +34-922-678000 Fax: +34-922-647112
Received: May 25, 2018
Peer-review started: May 25, 2018
First decision: July 4, 2018
Revised: August 18, 2018
Accepted: August 24, 2018
Article in press: August 24, 2018
Published online: October 7, 2018
Processing time: 128 Days and 20.8 Hours
Abstract

The outcome prediction of hepatocellular carcinoma (HCC) patients undergoing liver transplantation (LT) was classically established using various macromorphological factors and serum alpha-fetoprotein levels prior to LT. However, other biomarkers have recently been reported to be associated with the prognosis of HCC patients undergoing to LT. This review summarizes clinical data on these new biomarkers. High blood levels of malondialdehyde, total antioxidant capacity, caspase-cleaved cytokeratin-18, soluble CD40 ligand, substance P, C-reactive protein, and vascular endothelial growth factor, increased neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in blood, high peripheral blood expression of human telomerase reverse transcriptase messenger ribonucleic acid, and high HCC expression of dickkopf-1 have recently been associated with decreased survival rates. In addition, high blood levels of des-gamma-carboxy prothrombin, and high HCC expression of glypican-3, E-cadherin and beta-catenin have been associated with increased HCC recurrence. Additional research is necessary to establish the prognostic role of these biomarkers in HCC prior to LT. Furthermore, some of these biomarkers are also interesting because their potential modulation could help to create new research lines for improving the outcomes of those patients.

Keywords: Liver transplantation; Hepatocellular carcinoma; Biomarkers; Outcome; Survival; Recurrence; Genomic

Core tip: The outcome of liver transplantation (LT) for hepatocellular carcinoma (HCC) patients are generally predicted using various macromorphological factors and serum alpha-fetoprotein levels prior to LT. However, other biomarkers have recently been reported to be associated with the prognosis of HCC patients undergoing LT. Furthermore, some of these biomarkers are also interesting because their potential modulation could help to create new research lines for improving the outcomes of those patients. This review summarizes clinical data on those new biomarkers.