Hepatocellular carcinoma recurrence and death following living and deceased donor liver transplantation

R. A. Fisher, L. M. Kulik, C. E. Freise, A. S F Lok, T. H. Shearon, R. S. Brown, R. M. Ghobrial, Jeffrey Fair, K. M. Olthoff, I. Kam, C. L. Berg

Research output: Contribution to journalArticle

176 Citations (Scopus)

Abstract

We examined mortality and recurrence of hepatocellular carcinoma (HCC) among 106 transplant candidates with cirrhosis and HCC who had a potential living donor evaluated between January 1998 and February 2003 at the nine centers participating in the Adult-to-Adult Living Donor Liver Transplantation Cohort Study (A2ALL). Cox regression models were fitted to compare time from donor evaluation and time from transplant to death or HCC recurrence between 58 living donor liver transplant (LDLT) and 34 deceased donor liver transplant (DDLT) recipients. Mean age and calculated Model for End-Stage Liver Disease (MELD) scores at transplant were similar between LDLT and DDLT recipients (age: 55 vs. 52 years, p = 0.21; MELD: 13 vs. 15, p = 0.08). Relative to DDLT recipients, LDLT recipients had a shorter time from listing to transplant (mean 160 vs. 469 days, p <0.0001) and a higher rate of HCC recurrence within 3 years than DDLT recipients (29% vs. 0%, p = 0.002), but there was no difference in mortality or the combined outcome of mortality or recurrence. LDLT recipients had lower relative mortality risk than patients who did not undergo LDLT after the center had more experience (p = 0.03). Enthusiasm for LDLT as HCC treatment is dampened by higher HCC recurrence compared to DDLT.

Original languageEnglish (US)
Pages (from-to)1601-1608
Number of pages8
JournalAmerican Journal of Transplantation
Volume7
Issue number6
DOIs
StatePublished - Jun 2007
Externally publishedYes

Fingerprint

Living Donors
Liver Transplantation
Hepatocellular Carcinoma
Recurrence
Liver
Transplants
Tissue Donors
End Stage Liver Disease
Mortality
Proportional Hazards Models
Transplant Recipients
Fibrosis
Cohort Studies

Keywords

  • A2ALL
  • DDLT
  • HCC
  • LDLT
  • MELD
  • Recurrence

ASJC Scopus subject areas

  • Immunology

Cite this

Fisher, R. A., Kulik, L. M., Freise, C. E., Lok, A. S. F., Shearon, T. H., Brown, R. S., ... Berg, C. L. (2007). Hepatocellular carcinoma recurrence and death following living and deceased donor liver transplantation. American Journal of Transplantation, 7(6), 1601-1608. https://doi.org/10.1111/j.1600-6143.2007.01802.x

Hepatocellular carcinoma recurrence and death following living and deceased donor liver transplantation. / Fisher, R. A.; Kulik, L. M.; Freise, C. E.; Lok, A. S F; Shearon, T. H.; Brown, R. S.; Ghobrial, R. M.; Fair, Jeffrey; Olthoff, K. M.; Kam, I.; Berg, C. L.

In: American Journal of Transplantation, Vol. 7, No. 6, 06.2007, p. 1601-1608.

Research output: Contribution to journalArticle

Fisher, RA, Kulik, LM, Freise, CE, Lok, ASF, Shearon, TH, Brown, RS, Ghobrial, RM, Fair, J, Olthoff, KM, Kam, I & Berg, CL 2007, 'Hepatocellular carcinoma recurrence and death following living and deceased donor liver transplantation', American Journal of Transplantation, vol. 7, no. 6, pp. 1601-1608. https://doi.org/10.1111/j.1600-6143.2007.01802.x
Fisher, R. A. ; Kulik, L. M. ; Freise, C. E. ; Lok, A. S F ; Shearon, T. H. ; Brown, R. S. ; Ghobrial, R. M. ; Fair, Jeffrey ; Olthoff, K. M. ; Kam, I. ; Berg, C. L. / Hepatocellular carcinoma recurrence and death following living and deceased donor liver transplantation. In: American Journal of Transplantation. 2007 ; Vol. 7, No. 6. pp. 1601-1608.
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