2 years. The Kaplan Meier 1- and 5-year post-LT survival was 92.8% and 72.1% for waiting time < 6 months, versus 93.1% and 78.6% for waiting time ≥ 6 months (p=0.02). Cumulative probabilities of HCC recurrence at 6 months, 1 and 5 years post-LT were 6.4%, 7.7% and 16.8% with waiting time < 6 months versus 2.0%, 4.6% and 10.9% with waiting time ≥ 6 months, respectively (p=0.048). Predictors of HCC recurrence in multivariate analysis included microvascular

invasion (HR 3.8, 95% CI 2.2-6.4, p<0.001), explant tumor > Milan criteria (HR 3.2, 95% CI 1.4-7.1, p=0.005), and alpha-fetopro-tein Bioactive Compound Library screening >100 at transplant (HR 2.6, 95% CI 1.6-4.3, p<0.001). Waiting time < 6 months was a predictor of HCC recurrence in univariate (HR 1.5, 95% CI 1.001-2.4, p=0.049) but not in multivariate analysis. However, waiting time < 6 months was the only pre-LT factor predicting early HCC recurrence within 6 months after LT in multivariate analysis (HR 3.0, 95% CI 1.2-7.0, p=0.015). In conclusion, this large multi-center study provides evidence of an association between short waiting time and early HCC recurrence after LT. A minimal observation of 6 months from HCC diagnosis and LRT to LT may select out patients at increased risk for early post-LT HCC recurrence, thus supporting the “ablate and wait” principle in candidate selection while on the LT waiting list. Disclosures: The following people have nothing to disclose: Neil Mehta, Julie

Heimbach, Denise M. Harnois, Jennifer L. Dodge, Justin M. Burns, David Cilomilast Lee, William Sanchez, John P. Roberts, Francis Y. Yao Background: HCC recurrence is a major impediment to effective treatment of HCC by LT. Despite using the Milan criteria for candidate selection, up to 20% of HCC patients develop recurrence after LT and consequently have poor survival. This limits the benefit/risk ratio of LT for HCC patients compared to patients with benign liver disease. In order to

optimize organ allocation strategies, other objective preoperative parameters that can reliably predict the risk for recurrence post-LT are needed. Aims: To determine the association between pre-LT alpha-fetoprotein (AFP), lens culinaris agglutinin-reactive AFP (AFP-L3) and des-gamma-carboxy prothrombin (DCP) alone, or in combination with other biomarkers or 上海皓元医药股份有限公司 Milan criteria and risk of HCC recurrence after LT Methods: A retrospective cohort study of HCC patients undergoing LT between 2000 and 2008 was conducted. Of the 313, 127 had available serum samples drawn before LT. Serum AFP, AFP-L3% and DCP were measured in a blinded fashion using the μTASWako i30 immunoanalyzer. The hazard ratio (HR) and 95% confidence interval (95%CI) were calculated using Cox Proportional Hazards analysis. Results: Of the variables examined, tumor size, the Milan criteria and high levels of biomarkers were significantly associated with HCC recurrence. HRs (95%CI) were 1.4 (1.1-1.7) for tumor size, 2.6 (1.4-4.7) for tumor stage outside Milan criteria, 2.8 (1.4-5.4) for AFP ≥250 ng/ mL, 3.2 (1.