Korean J Transplant 2022; 36(Suppl 1): S36-S36
Published online November 17, 2022
https://doi.org/10.4285/ATW2022.F-1344
© The Korean Society for Transplantation
Shin Hwang1, Woo-Hyoung Kang1, Jong Man Kim2, Kwang-Woong Lee3, Dong Jin Joo4, Young Kyoung You5, Je Ho Ryu1, Bong-Wan Kim6, Donglak Choi7, Dong-Sik Kim8
1Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
2Department of Surgery, Samsung Medical Center, Seoul, Korea
3Department of Surgery, Seoul National University Hospital, Seoul, Korea
4Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
5Department of Surgery, The Catholic University of Korea Seoul St. Mary’s Hospital, Seoul, Korea
6Department of Surgery, Ajou University Hospital, Suwon, Korea
7Department of Surgery, Daegu Catholic University Medical Center, Daegu, Korea
8Department of Surgery, Korea University Anam Hospital, Seoul, Korea
Correspondence to: Shin Hwang
E-mail:
Background: This study intended to analyze pretransplant alpha-fetoprotein (AFP) and proteins induced by vitamin K absence or antagonist-II (PIVKA-II) in liver transplantation (LT) candidates.
Methods: A total of 3,273 LT recipients enrolled at the Korean Organ Transplantation Registry were divided according to hepatocellular carcinoma (HCC) status and background liver disease, and AFP and PIVKA-II were compared.
Results: In all patients, the median AFP and PIVKA-II were 6.3 ng/mL and 29 mAU/mL in viable HCC group and 3.3 ng/mL and 35 mAU/mL respectively in no HCC group (P<0.001 for AFP and P=0.037 for PIVKA-II). In hepatitis B virus-associated patients, they were 6.0 ng/mL and 26 mAU/mL in HCC group and 3.2 ng/mL and 21 mAU/mL in no HCC group, respectively (P<0.001 and P<0.001). In hepatitis C virus-associated patients, they were 10.7 ng/mL and 37 mAU/mL in HCC group and 2.6 ng/mL and 21 mAU/mL in no HCC group, respectively (P<0.001 and P=0.117). In ALD patients, they were 5.2 ng/mL and 61 mAU/mL in HCC group and 6.4 ng/mL and 75 mAU/mL in no HCC group, respectively (P<0.001 and P=0.419). In patients with other diseases, they were 7.1 ng/mL and 32 mAU/mL in HCC group and 3.3 ng/mL and 28 mAU/mL in no HCC group, respectively (P<0.001 and P=0.822).
Conclusions: The results of the present study indicate that pretransplant serum AFP and PIVKA-II were highly variably expressed in LT candidates with end-stage liver diseases, thus their values should be cautiously interpreted because their role for HCC diagnosis is limited.