International Journal of General Medicine (Sep 2021)

Impact of Hypothyroidism on Patients with Hepatocellular Carcinoma Undergoing Liver Transplantation

  • Salman A,
  • Aon M,
  • Hussein A,
  • Salman M,
  • Tourky M,
  • Mahmoud A,
  • Aljarad F,
  • Elkaseer M,
  • Shaaban HE,
  • Moustafa A,
  • El-Mikkawy A,
  • Gaballa N,
  • Abdallah H,
  • Zaky Rashed ZF,
  • Elkassar H

Journal volume & issue
Vol. Volume 14
pp. 5711 – 5718

Abstract

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Ahmed Salman,1 Mohamed Aon,1 Amr Hussein,2 Mohamed Salman,3 Mohamed Tourky,4 Ahmed Mahmoud,5 Feras Aljarad,6 Mohamed Elkaseer,7 Hossam El-Din Shaaban,8 Ahmed Moustafa,9 Ahmed El-Mikkawy,10 Nahla Gaballa,11 Heba Abdallah,12 Zaky Ftouh Zaky Rashed,13,14 Hesham Elkassar1 1Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt; 2Internal Medicine Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt; 3General Surgery Department, Faculty of Medicine, Cairo University, Cairo, Egypt; 4Department of Surgery, Great Western Hospitals NHS Foundation Trust, Swindon, UK; 5Senior Clinical Fellow, Great Western Hospital NHS Foundation Trust, Swindon, UK; 6Lewisham and Greenwich NHS Trust, Lewisham, London, UK; 7General Surgery Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt; 8Hepatology and Gastroenterology Department, National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt; 9Department of Endemic Medicine and Hepatology, Faculty of Medicine, Cairo University, Cairo, Egypt; 10Hepatology and Gastroenterology Department, Theodor Bilharz Research Institute, Cairo, Egypt; 11Anesthesiology and Intensive Care Department, National Liver Institute, Menoufia University, Shibin El Kom, Egypt; 12Clinical Pathology Department, National Liver Institute, Menoufia University, Shibin El Kom, Egypt; 13Anesthesiology and Intensive Care Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt; 14Department of Anesthesia, College of Applied Sciences, Almaarefa university, Ad Diriyah, Riyadh, Saudi ArabiaCorrespondence: Ahmed SalmanInternal Medicine Department, Faculty of Medicine, Cairo University, EgyptTel +20 1000468664Email [email protected]: This work endeavored to explore the effect of hypothyroidism on mortality in subjects with HCC who underwent living-donor liver transplantation (LDLT).Methods: This prospective study included 107 patients with HCC subjected to LDLT, divided into hypothyroid group (n=53) and euthyroid group (n=54). The primary objectives were overall and disease-free survival (DFS).Results: Euthyroid and hypothyroid groups were comparable in all baseline characteristics except the age of patients. Overall survival (OS) of the whole group at 48 months was 68.8%, while the DFS was 60.2%. On univariate analysis, OS was negatively affected by the older age of the patients (p< 0.001) or the donor (p< 0.001), hypothyroidism (p=0.008), HBV (p=0.029), larger tumor size (p=0.023), and defective Milan criteria (p=0.022). On multivariate analysis, the age of the patients and donors was the independent factor affecting OS. On univariate analysis, DFS was negatively affected by older age of the patients (p < 0.001) or the donor (p=0.005), hypothyroidism (p=0.005), HBV (p=0.019), larger tumor size (p=0.023), and defective Milan criteria (p=0.020). On multivariate analysis, the age of the patients, thyroid status, and Milan criteria were the independent factors affecting DFS.Conclusion: Hypothyroidism is a risk factor for worse outcomes in HCC patients after liver transplantation.Keywords: hypothyroidism, hepatocellular carcinoma, liver transplantation

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