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Gut Microbiota Modulation:A Viable Strategy to Address Medical Needs in Hepatocellular Carcinoma and Liver Transplantation

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Engineering 2023年第10期29卷 59-72页

作者： Ze Xiang Jian Wu Jiarui Li Shusen Zheng Xuyong Wei Xiao Xu Department of Hepatobiliary and Pancreatic Surgery Affiliated Hangzhou First People’s HospitalSchool of MedicineZhejiang UniversityHangzhou 310006China School of Medicine Zhejiang UniversityHangzhou 310058China Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province Affiliated Hangzhou First People’s HospitalSchool of MedicineZhejiang UniversityHangzhou 310006China Department of Clinical Laboratory The Affiliated Suzhou Hospital of Nanjing Medical University&Suzhou Municipal HospitalGusu SchoolNanjing Medical UniversitySuzhou 215008China Shulan(Hangzhou)Hospital Zhejiang Shuren University School of MedicineHangzhou 310022China National Health Commission(NHC)Key Laboratory of Combined Multi-organ Transplantation the First Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhou 310003China

Hepatocellular carcinoma(HCC)is the most common malignancy of the liver,posing a significant threat to public health.Although liver transplantation(LT)is an effective treatment for HCC,ischemia–reperfusion(I/R)injury,transplant rejection,and complications after LT can greatly reduce its effectiveness.In recent years,transplant oncology has come into being,a comprehensive discipline formed by the intersection and integration of surgery,oncology,immunology,and other related disciplines.Gut microbiota,an emerging field of research,also plays a crucial role.Through the microbiome–gut–liver axis,the gut microbiota has an impact on the onset and progression of HCC as well as LT.This review summarizes the mechanisms by which the gut microbiota affects HCC and its bidirectional interactions with chronic liver disease that can develop into HCC as well as the diagnostic and prognostic value of the gut microbiota in HCC.In addition,gut microbiota alterations after LT were reviewed,and the relationship between the gut microbiota and liver I/R injury,the efficacy of immunosuppressive drugs used,and complications after LT were discussed.In the era of LT oncology,the role of the gut microbiota in HCC and LT should be emphasized,which can provide new insights into the management of HCC and LT via gut microbiota modulation.

关键词： Gut microbiota Hepatocellular carcinoma(HCC) Liver transplantation(LT) Clinical value Mediating mechanism

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Visual analysis of mesenchymal stem cell research in liver disease based on bibliometrics

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iLIVER 2022年第4期1卷 283-291页

作者： Chengzuo Han Rui Wang Nan Xu Xuyong Wei Qiang wei Xiao Xu Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province Department of Hepatobiliary and Pancreatic SurgeryAffiliated Hangzhou First People's HospitalZhejiang University School of MedicineHangzhou310006China Westlake Laboratory of Life Sciences and Biomedicine Hangzhou310024China

The research of mesenchymal stem cells(MSCs)in the field of liver diseases has received more and more attention.This paper introduces the current situation,hot spots,and development trends in this field.Compre-hensive searches were conducted using Web of Science Core Collection from January 1,2000 to December 13,2021 with the following keywords:TS(topic)¼(liver*OR hepatic*OR hepatocyte)AND TS(topic)¼(Mesen-chymal stem cell*).VOSviewer(version 1.6.16)and CiteSpace V are used as bibliometric tools to analyze and visualize the knowledge graph.A total of 4452 papers were included in this study,and the number of research papers on MSCs in the field of liver diseases increased from January 2000 to December 2020.Eighty-four countries and regions have published articles on research in this field,among which China and the United States are the main two countries of publication.Based on the keyword burst detection,we find that the research in this field has shifted from basic research to clinical application,from medical research to interdisciplinary research.Tissue engineering and regenerative medicine are the frontier fields of MSCs research in liver diseases.Multicountry,multi-author cooperation,and multi-disciplinary intersection are the research trends in this field.Exocrine body,obesity,and tissue engineering are the hotspots in this field.

关键词： Mesenchymal stem cells Liver disease Bibliometrics Visualization

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Fibroblast growth factor 21(FGF21) attenuates tacrolimus-induced hepatic lipid accumulation through transcription factor EB(TFEB)-regulated lipophagy

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2023年第6期24卷 485-495页

作者： Zhensheng ZHANG Li XU Xun QIU Xinyu YANG Zhengxing LIAN Xuyong Wei Di LU Xiao XU Zhejiang University School of Medicine Hangzhou 310058China Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province Hangzhou 310006China Department of Hepatobiliary and Pancreatic Surgery the First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China Institute of Organ Transplantation Zhejiang UniversityHangzhou 310003China NHC Key Laboratory of Combined Multi-organ Transplantation Hangzhou 310003China Westlake Laboratory of Life Sciences and Biomedicine Hangzhou 310024China

Tacrolimus(TAC),also called FK506,is one of the classical immunosuppressants to prevent allograft rejection after liver transplantation.However,it has been proved to be associated with post-transplant hyperlipemia.The mechanism behind this is unknown,and it is urgent to explore preventive strategies for hyperlipemia after transplantation.Therefore,we established a hyperlipemia mouse model to investigate the mechanism,by injecting TAC intraperitoneally for eight weeks.After TAC treatment,the mice developed hyperlipemia(manifested as elevated triglyceride(TG)and low-density lipoprotein cholesterol(LDL-c),as well as decreased high-density lipoprotein cholesterol(HDL-c)).Accumulation of lipid droplets was observed in the liver.In addition to lipid accumulation,TAC induced inhibition of the autophagy-lysosome pathway(microtubule-associated protein 1light chain 3β(LC3B)II/I and LC3B II/actin ratios,transcription factor EB(TFEB),protein 62(P62),and lysosomal-associated membrane protein 1(LAMP1))and downregulation of fibroblast growth factor 21(FGF21)in vivo.Overexpression of FGF21may reverse TAC-induced TG accumulation.In this mouse model,the recombinant FGF21 protein ameliorated hepatic lipid accumulation and hyperlipemia through repair of the autophagy-lysosome pathway.We conclude that TAC downregulates FGF21and thus exacerbates lipid accumulation by impairing the autophagy-lysosome pathway.Recombinant FGF21 protein treatment could therefore reverse TAC-caused lipid accumulation and hypertriglyceridemia by enhancing autophagy.

关键词： Autophagy Fibroblast growth factor 21(FGF21) Lipid Lipophagy Lysosome Tacrolimus Transcription factor EB(TFEB)

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Molecular phenotypes reveal heterogeneous engraftments of patient-derived hepatocellular carcinoma xenografts

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Chinese Journal of Cancer Research 2021年第4期33卷 470-479页

作者： Jianyong Zhuo Di Lu Jianguo Wang Zhengxing Lian Jiali Zhang Huihui Li Beini Cen Xuyong Wei Qiang wei Haiyang Xie Xiao Xu Department of Hepatobiliary and Pancreatic Surgery The Center for Integrated Oncology and Precision MedicineAffiliated Hangzhou First People’s HospitalZhejiang University School of MedicineHangzhou 310003China Department of Hepatobiliary and Pancreatic Surgery the First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China National Health Commission Key Laboratory of Combined Multi-organ Transplantation Institute of Organ TransplantationZhejiang UniversityHangzhou 310003China

Objective:Patient-derived xenograft(PDX)models provide a promising preclinical platform for hepatocellular carcinoma(HCC).However,the molecular features associated with successful engraftment of PDX models have not been revealed.Methods:HCC tumor samples from 76 patients were implanted in immunodeficient mice.The molecular expression was evaluated by immunohistochemistry.Patient and tumor characteristics as well as tumor molecular expressions were compared for PDX engraftment using the Chi-square test.The independent prediction parameters were identified by logistic regression analyses.Results:The engraftment rate for PDX models from patients with HCC was 39.47%(30/76).Tumors from younger patients and patients with elevated preoperative alpha-fetoprotein level had higher engraftment rates.Tumors with poor differentiation and vascular invasion were related to engraftment success.The positive expression of CK19,CD133,glypican-3(GPC3),and Ki67 in tumor samples was associated with engraftment success.Logistic regression analyses indicated that GPC3 and Ki67 were two of the strongest predictors of PDX engraftment.Tumors with GPC3/Ki67 phenotypes showed heterogeneous engraftment rates,with 71.9%in GPC3^(+)/Ki67^(+)tumors,30.8%in GPC3^(-)/Ki67^(+)tumors,15.0%in GPC3^(+)/Ki67^(-)tumors,and 0 in GPC3^(-)/Ki67^(-)tumors.Conclusions:Successful engraftment of HCC PDXs was significantly related to molecular features.Tumors with the GPC3+/Ki67+phenotype were the most likely to successfully establish HCC PDXs.

关键词： Hepatocellular carcinoma patient-derived xenografts heterogeneous establishment molecular phenotype

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Clinical characteristics of postoperative necrotizing enterocolitis in patients with congenital jejunoileal atresia and its risk factors

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World Journal of Pediatric Surgery 2024年第1期7卷 42-46页

作者： Xiaofeng Xiong wei Lu Fuzhong Xing Yuan Cai Jixin Yang Yuhang Yuan Jiexiong Feng xuyong Chen Department of Pediatric Surgery Tongji Hospital of Tongji Medical College of Huazhong University of Science and TechnologyWuhanHubeiChina Department of Neonate Surgery Wuhan Children's HospitalHuazhong University of Science and TechnologyWuhanHubeiChina Department of Pediatric Surgery The First Affiliated Hospital of Zhengzhou UniversityZhengzhouHenanChina

Objective To review postoperative necrotizing enterocolitis(NEC)in patients with jejunoileal atresia(JIA)and to explore the potential risk factors related to the concurrence ofNEC.Methods Patients diagnosed with JIA who received surgical treatment from January 2016 to June 2021 were enrolled.Demographics,viral infection of the fetus,transfusion within 48 hours before NEC,sepsis before JIA repair,pathological and anatomical classification of JIA,combined malformation,occurrence time of NEC after the operation,treatment,and prognosis of patients were analyzed.Patients were divided into NEC group and non-NEC group,and all patients were followed up for 3-6 months to observe for complications.Results A total of 180 patients with JIA were included,of whom 12 were diagnosed with NEC after surgery and 1 patient with NEC died during follow-up.The average age,birth weight,gestational age,proportion of premature infants,proportion of preoperative infections,and pathological classification of JIA did not significantly differ between the two groups.The probability of patients with proximal jejunal atresia(PJA)in the NEC group(58.3%)was higher than that in the non-NEC group(22.6%)(p=0.011),and patients with PJA had longer parenteral nutrition time than patients without PJA(26.64±9.21 days vs 15.11±6.58 days,p<0.001).Conclusion PJA was more likely to be associated with concurrent NEC after surgery,which is a highly NEC-related risk factor inherent in JIA.

关键词： patients postoperative transfusion

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Extrahepatic organs in the development of non-alcoholic fatty liver disease in liver transplant patients

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Hepatobiliary Surgery and Nutrition 2022年第3期11卷 400-411页

作者： Renyi Su Xuyong Wei Qiang wei Di Lu Zuyuan Lin Shuo Wang Chuxiao Shao Xiao Xu Department of Hepatobiliary and Pancreatic Surgery Affiliated Hangzhou First People’s HospitalZhejiang University School of MedicineHangzhouChina NHC Key Laboratory of Combined Multi-Organ Transplantation HangzhouChina Department of Hepatobiliary and Pancreatic Surgery Shu Lan HospitalShu Lan International Medical College of Zhejiang Shuren UniversityHangzhouChina Department of Hepatobiliary and Pancreatic Surgery Affiliated Lishui HospitalZhejiang University School of MedicineLishuiChina

Background and Objective:Non-alcoholic fatty liver disease(NAFLD)is highly prevalent in patients who undergo liver transplantation(LT).Whereas there is huge data on NAFLD,little is known about NAFLD in LT.In this review,we aim to explore extrahepatic organs and their potential mechanisms in the development of NAFLD in LT patients and discuss current limitations in preclinical and clinical scenarios with suggestions for future study.Methods:The following keywords,such as NAFLD,NASH,liver transplant,therapy,pathogenesis and biomarkers,were set for literature retrieval.The articles which were published articles in English till 25th June 2020 in PubMed database were included,and there is no limit for the study design type.Key Content and Findings:Following LT,there are significant shifts in the microbiota and farnesoid X receptor may be a potential therapeutic target for NAFLD in LT settings.The roles of probiotics and diet on NALFD remain inconclusive in LT background.Nevertheless,the adipokines and cytokines disorder and local insulin resistance of adipose tissue may contribute to NAFLD process.Bariatric surgeries are promising in controlling de novo and recurrent NAFLD with significant reduction in abdominal adipose tissue,despite the optimal timing is inconclusive in LT cases.Furthermore,circumstantial evidence indicates that miRNA-33a may function as a mediator bridging sarcopenia and NAFLD of post-LT.β-Hydroxy-β-Methyl-Butyrate treatment could improve muscle status in graft recipients and shows protective potential for NAFLD in LT settings.Conclusions:Gut,adipose tissue and muscle are intricately intertwined in promoting NAFLD in LT cases.Further animal studies are needed to deepen our understanding of mechanisms in multi-organ crosstalk.High quality clinical trials are warrant for making guidelines and developing management strategies on NAFLD after LT.

关键词： Non-alcoholic fatty liver disease(NAFLD) liver transplant sarcopenia lipid gut

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TNFR2 is a potent prognostic biomarker for post-transplant lung metastasis in patients with hepatocellular carcinoma

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Chinese Journal of Cancer Research 2023年第1期35卷 66-80页

作者： Huigang Li Zuyuan Lin Jianyong Zhuo Modan Yang wei Shen Zhihang Hu Yichen Ding Hao Chen Chiyu He Xinyu Yang Siyi Dong Xuyong Wei Beicheng Sun Shusen Zheng Ren Lang Di Lu Xiao Xu Zhejiang University School of Medicine Hangzhou 310058China Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province Department of Hepatobiliary and Pancreatic SurgeryAffiliated Hangzhou First People's HospitalZhejiang University School of MedicineHangzhou 310006China The Institute for Organ Repair and Regenerative Medicine of Hangzhou Hangzhou 310006China Institute of Organ Transplantation Zhejiang UniversityHangzhou 310003China National Center for Healthcare Quality Management in Liver Transplant Hangzhou 310003China Department of Hepatobiliary Surgery the Affiliated Drum Tower Hospital of Nanjing University Medical SchoolNanjing 210008China Department of Hepatobiliary and Pancreatic Surgery the First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China Department of Hepatobiliary and Pancreatic Surgery Shulan(Hangzhou)HospitalHangzhou 311112China NHC Key Laboratory of Combined Multi-organ Transplantation Hangzhou 31003China Department of Hepatobiliary Surgery Beijing Chaoyang Hospital Affiliated to Capital Medical UniversityBeijing 100020China

Objective:Lung metastasis is a common and fatal complication of liver transplantation for hepatocellular carcinoma(HCC).The precise prediction of post-transplant lung metastasis in the early phase is of great value.Methods:The mRNA profiles of primary and paired lung metastatic lesions were analyzed to determine key signaling pathways.We enrolled 241 HCC patients who underwent liver transplantation from three centers.Tissue microarrays were used to evaluate the prognostic capacity of tumor necrosis factor(TNF),tumor necrosis factor receptor 1(TNFR1),and TNFR2,particularly for post-transplant lung metastasis.Results:Comparison of primary and lung metastatic lesions revealed that the TNF-dependent signaling pathway was related to lung metastasis of HCC.The expression of TNF was degraded in comparison to that in para-tumor tissues(P<0.001).The expression of key receptors in the TNF-dependent signaling pathway,TNFR1 and TNFR2,was higher in HCC tissues than in para-tumor tissues(P<0.001).TNF and TNFR1 showed no relationship with patients’outcomes,whereas elevated TNFR2 in tumor tissue was significantly associated with worse overall survival(OS)and increased recurrence risk(5-year OS rate:31.9%vs.62.5%,P<0.001).Notably,elevated TNFR2 levels were also associated with an increased risk of post-transplant lung metastasis(hazard ratio:1.146;P<0.001).Cox regression analysis revealed that TNFR2,Hangzhou criteria,age,and hepatitis B surface antigen were independent risk factors for post-transplant lung metastasis,and a novel nomogram was established accordingly.The nomogram achieved excellent prognostic efficiency(area under time-dependent receiver operating characteristic=0.755,concordance-index=0.779)and was superior to conventional models,such as the Milan criteria.Conclusions:TNFR2 is a potent prognostic biomarker for predicting post-transplant lung metastasis in patients with HCC.A nomogram incorporating TNFR2 deserves to be a helpful prognostic tool in liver transplantation for HCC.

关键词： Lung metastasis hepatocellular carcinoma liver transplantation nomogram

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肠道菌群调节在肝细胞癌和肝移植中的应用（英文）

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Engineering 2023年第10期 59-72页

作者： Ze Xiang Jian Wu Jiarui Li Shusen Zheng Xuyong Wei Xiao Xu Department of Hepatobiliary and Pancreatic Surgery Affiliated Hangzhou First People’s Hospital School of Medicine Zhejiang University School of Medicine Zhejiang University Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province Affiliated Hangzhou First People’s Hospital School of Medicine Zhejiang University Department of Clinical Laboratory The Affiliated Suzhou Hospital of Nanjing Medical University&Suzhou Municipal Hospital Gusu School Nanjing Medical University Shulan(Hangzhou)Hospital Zhejiang Shuren University School of Medicine National Health Commission(NHC)Key Laboratory of Combined Multi-organ Transplantation the First Affiliated Hospital School of Medicine Zhejiang University

Hepatocellular carcinoma(HCC) is the most common malignancy of the liver, posing a significant threat to public health. Although liver transplantation(LT) is an effective treatment for HCC, ischemia–reperfusion(I/R) injury, transplant rejection, and complications after LT can greatly reduce its effectiveness. In recent years, transplant oncology has come into being, a comprehensive discipline formed by the intersection and integration of surgery, oncology, immunology, and other related disciplines. Gut microbiota, an emerging field of research, also plays a crucial role. Through the microbiome–gut–liver axis, the gut microbiota has an impact on the onset and progression of HCC as well as LT. This review summarizes the mechanisms by which the gut microbiota affects HCC and its bidirectional interactions with chronic liver disease that can develop into HCC as well as the diagnostic and prognostic value of the gut microbiota in HCC. In addition, gut microbiota alterations after LT were reviewed, and the relationship between the gut microbiota and liver I/R injury, the efficacy of immunosuppressive drugs used, and complications after LT were discussed. In the era of LT oncology, the role of the gut microbiota in HCC and LT should be emphasized, which can provide new insights into the management of HCC and LT via gut microbiota modulation.

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Stratified Analysis of Survival Benefit for ABO-incompatible Deceased-donor Liver Transplantation:Multicenter Propensity Score-matched Study

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Journal of Clinical and Translational Hepatology 2023年第4期11卷 827-838页

作者： Mengfan Yang Xuyong Wei Abdul Rehman Khan Qiang wei Rui Wang Binhua Pan Kun Wang Zhisheng Zhou Di Lu Beini Cen Shuijun Zhang Wenzhi Guo Shusen Zheng Yang Yang Xiao Xu Department of Organ Transplantation Qilu Hospital of Shandong UniversityJinanShandongChina Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province HangzhouZhejiangChina Department of Hepatobiliary and Pancreatic Surgery Affiliated Hangzhou First People’s HospitalZhejiang University School of MedicineHangzhouZhejiangChina Zhejiang University School of Medicine HangzhouZhejiangChina National Center for Healthcare Quality Management in Liver Transplant HangzhouZhejiangChina Department of Hepatobiliary and Pancreatic Surgery The First Affiliated Hospital of Zhengzhou UniversityHenanChina Department of Hepatobiliary and Pancreatic Surgery The First Affiliated HospitalZhejiang University School of MedicineHangzhouZhejiangChina Department of Hepatobiliary and Pancreatic Surgery Shulan(Hangzhou)HospitalHangzhouZhejiangChina Department of Hepatobiliary and Pancreatic Surgery The Third Affiliated Hospital of Sun Yat-Sen UniversityGuangzhouGuangdongChina

Background and Aims:Liver transplantation(LT)using ABO-incompatible(ABOi)grafts can extend the donor pool to a certain extent and hence reduce the waiting time for transplantation.However,concerns of the impending prognosis associated with this option,especially for patients with liver failure and higher model for end-stage liver disease(MELD)scores,who tend to be more fragile during the waiting period before LT.Methods:Recipients undergoing LT for acute-onchronic liver failure or acute liver failure were retrospectively enrolled at four institutions.Overall survival was compared and a Cox regression analysis was performed.Propensity score matching was performed for further comparison.Patients were stratified by MELD score and cold ischemia time(CIT)to determine the subgroups with survival benefits.Results:Two hundred ten recipients who underwent ABOi LT and 1,829 who underwent ABO compatible(ABOc)LT were enrolled.The 5-year overall survival rate was significantly inferior in the ABOi group compared with the ABOc group after matching(50.6%vs.75.7%,p0.05).Comparison of the survival rates revealed no statistically significant difference for patients with MELD scores≥40(p>0.05).For patients with MELD scores of 31-39,the overall survival rate was significantly inferior in the ABOi group compared with the ABOc group(p<0.001);however,the rate was increased when the liver graft CIT was<8 h.Conclusions:For recipients with MELD scores≤30,ABOi LT had a prognosis comparable to that of ABOc LT and can be regarded as a feasible option.For recipients with MELD scores≥40,ABOi should be adopted with caution in emergency cases.For recipients with MELD scores of 31-39,the ABOi LT prognosis was worse.However,those patients benefited from receiving ABOi grafts with a CIT of<8 h.

关键词： Liver transplantation ABO-incompatible Model for end-stage liver disease score Cold ischemia time Propensity score matching

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A novel nomogram for prognosis stratification in salvage liver transplantation:a national-wide study with propensity score matching analysis in China

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Hepatobiliary Surgery and Nutrition 2023年第6期12卷 854-867,I0006-I0009页

作者： Kai Wang Fengqiang Gao Siyi Dong Jialu Ding Libin Dong Chuxiao Shao Zhoucheng Wang Xun Qiu Xuyong Wei Zhengxin Wang Jiayin Yang Qiang Xia Shusen Zheng Xiao Xu Department of Hepatobiliary and Pancreatic Surgery Affiliated Hangzhou First People’s HospitalZhejiang University School of MedicineHangzhouChina Institute of Organ Transplantation Zhejiang UniversityHangzhouChina Key Laboratory of Integrated Oncology and Intelligent Medicine of Zhejiang Province Affiliated Hangzhou First People’s HospitalZhejiang University School of MedicineHangzhouChina NHC Key Laboratory of Combined Multi-organ Transplantation HangzhouChina Zhejiang University School of Medicine HangzhouChina Department of Hepatobiliary and Pancreatic Surgery Affiliated Lishui HospitalZhejiang University School of MedicineLishuiChina National Center for Healthcare Quality Management in Liver Transplant HangzhouChina Graduate School Nanjing University of Chinese MedicineNanjingChina Department of General Surgery Huashan HospitalFudan UniversityShanghaiChina Liver Transplantation Center Department of Liver SurgeryWest China Hospital of Sichuan UniversityChengduChina Department of Liver Surgery Ren Ji HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghaiChina Department of Hepatobiliary and Pancreatic Surgery the First Affiliated HospitalZhejiang University School of MedicineHangzhouChina Department of Hepatobiliary and Pancreatic Surgery Shulan Hospital of HangzhouHangzhouChina

Background:Salvage liver transplantation(SLT)has been reported to be an efficient treatment option for patients with recurrent hepatocellular carcinoma(HCC)after liver resection(LR).However,for recipients who underwent liver transplantation(LT)due to recurrent HCC after LR in China,the selection criteria are not well established.Methods:In this study,data from the China Liver Transplant Registry(CLTR)of 4,244 LT performed from January 2015 to December 2019 were examined,including 3,498 primary liver transplantation(PLT)and 746 SLT recipients.Propensity score matching(PSM)analysis was used to minimize between-group imbalances.The overall survival(OS)and disease-free survival(DFS)between PLT and SLT in recipients fulfilling the Milan or Hangzhou criteria were compared based on the multivariate analysis,nomograms were plotted to further classify the SLT group into low-and high-risk groups.Results:In this study,the 1-,3-and 5-year OS and DFS of SLT recipients fulfilling Milan criteria(OS,P=0.01;DFS,P<0.001)or Hangzhou criteria(OS,P=0.03;DFS,P=0.003)were significantly reduced when compared to that of PLT group after PSM analysis.Independent risk factors,including preoperative transarterial chemoembolization(TACE),alpha fetoprotein(AFP)level,tumor maximum size and tumor total diameter were selected to draw a prognostic nomogram.The low-risk SLT recipients(1-year,95.34%;3-year,84.26%;5-year,77.20%)showed a comparable OS with PLT recipients fulfilling Hangzhou criteria (P=0.107). Conclusions: An optimal nomogram model for prognosis stratification and clinical decision guidance of SLT was established. The low-risk SLT recipients based on the nomograms showed comparable survival with those fulfilling Hangzhou criteria in PLT group.

关键词： Salvage liver transplantation(SLT) nomogram primary liver transplantation(PLT) overall survival(OS) disease-free survival(DFS)

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