Criteria-specific long-term survival prediction model for hepatocellular carcinoma patients after liver transplantation

Table 1 Characteristics of hepatocellular carcinoma patients and univariate assessment of long-term survival after liver transplantation n (%)

Variables	Value	P value
Age (yr)	47.99 ± 9.09	< 0.001
Gender		0.048
Male	204 (91.5)
Female	19 (8.5)
Blood type		0.951
A	66 (29.6)
B	62 (27.8)
O	75 (33.6)
AB	20 (9.0)
Identical	195 (87.4)	0.492
History
Cardiovascular disease	17 (7.6)	0.358
Respiratory disease	3 (1.3)	0.296
Diabetes mellitus	17 (7.6)	0.736
Hepatitis B virus infection	223 (100.0)	0.252
Ascites	144 (64.6)	0.426
Variceal bleeding	25 (11.2)	0.023
Encephalopathy	4 (1.8)	0.799
Treatment related to hepatocellular carcinoma
Hepatectomy	21 (9.4)	0.693
Transplantation	4 (1.8)	< 0.001
TACE	44 (19.7)	0.756
Criteria
Milan		< 0.001
Met	88 (39.5)
Exceeded	135 (60.5)
UCSF		< 0.001
Met	97 (43.5)
Exceeded	126 (56.5)
Shanghai Fudan		< 0.001
Met	116 (52.0)
Exceeded	107 (48.0)
Hangzhou		< 0.001
Met	144 (64.6)
Exceeded	79 (35.4)
MELD score	14.12 ± 7.02	0.086
SCr (μmol/L)	71.41 ± 69.10	0.173
TB (μmol/L)	89.45 ± 174.19	< 0.001
INR	1.42 ± 0.45	0.010
AFP (ng/mL)	5694.77 ± 12584.00	< 0.001
Cold ischemia time (h)	9.21 ± 2.07	0.129
Intraoperative blood loss (IU)	9.24 ± 8.50	0.002
Operation duration (h)	8.29 ± 1.58	0.200
Liver transplantation technique		0.001
Classic	212 (95.1)
Piggyback	11 (4.9)
Biliary reconstruction		< 0.001
Duct-to-duct	221 (99.1)
Roux-en-Y	2 (0.9)
Edmondson grading		0.790
I	8 (3.6)
II	200 (89.7)
III	13 (5.8)
IV	2 (0.9)

MELD: Model for end-stage liver disease; SCr: Serum creatinine; TB: Total bilirubin; INR: International normalized ratio; AFP: Alfa-fetoprotein; UCSF: University of California San Francisco; TACE: Transcatheter arterial chemoembolization.

Table 2 Long-term survival model for hepatocellular carcinoma patients after liver transplantation

Variables	Regression coefficient	Regression coefficient SE	P value	Hazard ratio	95%CI
Milan1
AFP (logevalue)	0.093	0.031	0.003	1.097	1.032-1.167
Intraoperative blood loss	0.038	0.009	< 0.001	1.039	1.021-1.057
Retransplantation	1.429	0.522	0.006	4.173	1.501-11.604
Criteria exceeded	1.504	0.253	< 0.001	4.500	2.741-7.386
University of California San Francisco2
AFP (logevalue)	0.090	0.031	0.003	1.094	1.030-1.161
Intraoperative blood loss	0.038	0.009	< 0.001	1.039	1.022-1.057
Retransplantation	1.373	0.522	0.009	3.947	1.419-10.976
Criteria exceeded	1.555	0.242	< 0.001	4.737	2.950-7.607
Shanghai Fudan3
AFP (logevalue)	0.091	0.031	0.003	1.096	1.031-1.165
Intraoperative blood loss	0.034	0.008	< 0.001	1.035	1.018-1.052
Retransplantation	1.296	0.523	0.013	3.654	1.311-10.182
Criteria exceeded	1.361	0.213	< 0.001	3.899	2.566-5.924
Hangzhou4
TB (logevalue)	0.186	0.094	0.049	1.204	1.001-1.449
Intraoperative blood loss	0.020	0.010	0.046	1.020	1.000-1.040
Retransplantation	1.312	0.520	0.012	3.715	1.340-10.295
Criteria exceeded	1.520	0.190	< 0.001	4.570	3.149-6.633

¹MHCAT (Milan) = 0.093 × LnAFP + 0.038 × IBL + 1.429 × Re (Re = 0 without retransplantation; Re = 1 with retransplantation) + 1.504 × Cri (Cri = 0 within criteria; Cri = 1 exceeding criteria);

²MHCAT (University of California San Francisco) = 0.090 × LnAFP + 0.038*IBL + 1.373 × Re (Re = 0 without retransplantation; Re = 1 with retransplantation) + 1.555 × Cri (Cri = 0 within criteria; Cri = 1 exceeding criteria);

³MHCAT (Fudan) = 0.091 × LnAFP +0.034 × IBL + 1.296 × Re (Re = 0 without retransplantation; Re = 1 with retransplantation) + 1.361 × Cri (Cri = 0 within criteria; Cri = 1 exceeding criteria);

⁴MHCAT (Hangzhou) = 0.186 × LnTB + 0.020 × IBL + 1.312 × Re (Re = 0 without retransplantation; Re = 1 with retransplantation) + 1.520 × Cri (Cri = 0 within criteria; Cri = 1 exceeding criteria). TB: Total bilirubin; AFP: Alfa-fetoprotein.