Impact of COVID-19 pandemic on clinicopathological features of transplant recipients with hepatocellular carcinoma: A case-control study

Table 1 Comparison of pre-pandemic and pandemic groups in terms of categorical variables

Variables	Pre-pandemic, n = 61	Pandemic, n = 48	Total, n = 109	P value
Sex (%)				0.629
Male	53 (86.9)	44 (91.7)	97 (89)
Female	8 (13.1)	4 (8.3	12 (11)
LT type				0.017
LDLT	54 (88.5)	48 (100)	102 (93.6)
DDLT	7 (11.5)	0 (0)	7 (6.4)
Child score				0.353
A	22 (36.1)	12 (25.0)	34 (31.2)
B	27 (44.3)	22 (45.8)	49 (45.0)
C	12 (19.7)	14 (29.2)	26 (23.8)
Milan criteria				0.337
Within	36 (59.0)	23 (47.9)	59 (54.1)
Beyond	25 (41.0)	25 (52.1)	50 (45.9)
UCSF criteria				0.450
Within	41 (67.2)	28 (58.3	69 (63.3)
Beyond	20 (32.8)	20 (41.7)	40 (36.7)
BCLC criteria				0.429
Within	46 (75.4)	32 (66.7)	78 (71.6)
Beyond	15 (24.6)	16 (33.3)	31 (28.4)
Tokyo (5-5 rule)				0.684
Within	44 (72.1)	32 (66.7)	76 (69.7)
Beyond	17 (27.9)	16 (33.3)	33 (30.3)
Onaca criteria				0.293
Within	45 (73.8)	30 (62.5)	75 (68.8)
Beyond	16 (26.2)	18 (37.5)	34 (31.2)
CUN navara criteria				0.450
Within	41 (67.2)	28 (58.3)	69 (63.3)
Beyond	20 (32.8)	20 (41.7)	40 (36.7)
Up-to-7 criteria				0.142
Within	46 (75.4)	29 (60.4)	75 (68.8)
Beyond	15 (24.6)	19 (39.4	34 (31.2)
AFP model				0.202
Within	45 (73.8)	29 (60.4)	74 (67.9)
Beyond	16 (26.2)	19 (39.6)	35 (32.1)
AFP-TTD criteria				0.223
Within	47 (77.0)	31 (64.6)	78 (71.6)
Beyond	14 (23.0)	17 (35.4)	31 (28.4)
Expanded Malatya criteria				0.826
Within	43 (70.5)	32 (66.7)	75 (68.8)
Beyond	18 (29.5)	16 (33.3)	34 (31.2)
5-5-500 rule				0.449
Within	43 (70.5)	30 (62.5)	73 (67.0)
Beyond	18 (29.5)	18 (37.5)	36 (33.0)
Samsung criteria				0.229
Within	47 (77.0)	32 (66.7)	79 (72.5)
Beyond	14 (23.0)	16 (33.3	30 (27.5)
Macrovascular invasion				0.284
Present	7 (11.5)	10 (20.8)	17 (15.6)
Absent	54 (88.5)	38 (79.2)	92 (84.4)
Tumor differentiation				0.066
Well	31 (50.8)	20 (41.7)	51 (46.8)
Moderate	23 (37.7)	14 (29.2)	37 (33.9)
Poor	7 (11.5)	14 (29.2)	21 (19.3)
Lympho-vascular invasion				0.019
Present	20 (32.8)	26 (55.3)	46 (42.6)
Absent	41 (67.2)	21 (44.7)	62 (57.4)
Perineural invasion				0.435
Present	0 (0.0)	1 (2.1)	1 (0.9)
Absent	61 (100)	46 (97.9)	108 (98.2)
Capsular inasion				0.651
Present	2 (3.3)	3 (6.4)	5 (4.6)
Absent	59 (96.7)	44 (93.6)	103 (94.5)
Tumor necrosis				0.526
Present	16 (26.2)	9 (19.1)	25 (22.9)
Absent	45 (73.8)	38 (80.9)	83 (76.1)
Locoregional therapy ascites				1.000
Yes	16 (26.2)	12 (25.0)	28 (25.7)
No	45 (73.8)	36 (75.0)	81 (74.3)
Ascites				0.113
Mild	32 (52.5)	25 (52.1)	57 (52.3)
Moderate	22 (36.1)	11 (22.9)	33 (30.3)
Massive	7 (11.5)	12 (25.0)	19 (17.4)
Outcome				0.953
Alive	52 (85.2)	42 (87.5)	94 (86.2)
Dead	9 (14.8)	6 (12.5)	15 (13.8)
Recurrence				0.693
Yes	4 (6.6)	2 (4.2)	6 (5.5)
No	57 (93.4)	46 (95.8)	103 (64.5)

AFP: Alpha fetoprotein; LT: Liver transplantation; LDLT: Living donor liver transplantation; DDLT: Deceased donor liver transplantation; TTD: Total diameter of the tumors.

Table 2 Comparison of pre-pandemic and pandemic groups in terms of continuous variables

Variables	Pre-pandemic		Pandemic		P value
	Median (IQR)	95%CI	Median (IQR)	95%CI
Age	56 (17)	52-59	56 (14)	53-59	0.685
BMI	26 (5)	24-27	27 (5)	25-28	0.352
Graft weight	810 (220)	760-825	827 (272)	735-920	0.925
MELD score	15 (10)	12-17	16 (8)	13-18	0.413
AFP level	9 (36)	5-13	11 (82)	6-25	0.643
Tumor number	1 (3)	1-2	2 (2)	1-3	0.256
TTD	3.3 (3.8)	2.5-4.5	3.7 (6.3)	2.0-6.0	0.712
Liver index score	7 (2)	7-7	7 (2)	7-8	0.417
Agg index	4.0 (2.0)	4.0-5.0	5.0 (2.5)	4.0-6.0	0.183
WBC	6.0 (2.8)	5.0-7.0	4.9 (3.2)	4.0-6.0	0.298
Hb	13.0 (3.7)	12.0-14.0	11.9 (3.5)	11.0-13.0	0.079
Platelets	95 (90)	77-113	83 (102)	58-128	0.363
Neutrophil	3.5 (2.7)	2.9-4.1	2.8 (2.2)	2.5-3.7	0.394
Lymphocyte	1.1 (0.9)	0.9-1.6	1.1 (0.9)	0.9-1.3	0.498
NLR	2.7 (2.9)	2.1-3.4	2.6 (1.9)	2.1-3.1	0.819
PLR	76 (50)	64-91	76 (61)	59-93	0.634
INR	1.26 (0.40)	1.22-1.37	1.33 (0.43)	1.28-1.46	0.112
Creatinine	0.8 (0.3)	0.7-0.9	0.8 (0.2)	0.7-0.9	0.955
Albumin	2.9 (1.2)	2.6-3.1	2.9 (1.1)	2.6-3.1	0.888
Total bilirubin	1.7 (2.3)	1.2-2.1	2.3 (4.0)	1.4-2.8	0.138
Direct bilirubin	0.8 (1.4)	0.6-1.0	1.1 (1.5)	0.7-1.3	0.306
AST	57 (47)	46-63	57 (67)	46-86	0.157
ALT	41 (38)	33-50	40 (32)	30-52	0.944
ALP	107 (74)	93-122	131 (123)	109-158	0.029
GGT	78 (83)	61-107	61 (78)	44-105	0.213
LDH	224 (91)	202-255	247 (99)	210-273	0.325
CRP	0.7 (1.4)	0.4-1.2	0.9 (1.8)	0.5-1.9	0.533

95% confidence interval (CI) for median values. BMI: Body mass index; AFP: Alpha fetoprotein; WBC: White blood cell; NLR: Neutrophil to lymphocyte ratio; PLR: Platelet to lymphocyte ratio; INR: International normalized ratio; AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; ALP: Alkaline phosphatase; GGT: Glutamyl transpeptidase; LDH: Lactate dehydrogenase; CRP: C-reactive protein; TTD: Total diameter of the tumors; Hb: Hemoglobin; IQR: Interquartile range.