TY - JOUR
T1 - Living donor liver transplantation for hepatocellular carcinoma
T2 - A single center analysis of outcomes and impact of different selection criteria
AU - Balci, Deniz
AU - Dayangac, Murat
AU - Yaprak, Onur
AU - Akin, Baris
AU - Duran, Cihan
AU - Killi, Refik
AU - Yuzer, Yildiray
AU - Tokat, Yaman
PY - 2011/11
Y1 - 2011/11
N2 - We examined the outcomes of patients who received living donor liver transplantation (LDLT) for HCC comparing the impact of up-to-seven criteria and Asan Criteria (AC) with Milan Criteria (MC). Between July 2004 and July 2009, of 175 consecutive LDLT, there were 45 consecutive patients with HCC. Forty patients who completed 12 months follow-up were enrolled. In search for the highest number of expansion, we selected AC as the extended criteria. Patients were divided into having tumors within MC, beyond MC within AC and Beyond Criteria (BC) groups. With a median follow-up of 46 months, overall 1, 3, and 5 years survival was -90%, -81%, and -70%, respectively. In patients within AC, estimated mean survival was 49.8 vs. 40.5 months for BC group (P = 0.2). Disease-free survival was significantly higher in patients within AC comparing with BC group; 48.0 vs. 38.6 months (P = 0.04). Preoperative AFP level >400 and poor tumor differentiation were factors adversely effecting recipient survival. On multivariate analysis, the presence of poor tumor differentiation (P = 0.018 RR: 2.48) was the only independent predictor of survival. Extension of tumor size and number to AC is feasible, without significantly compromising outcomes; however, the presence of poor tumor differentiation was associated with worse outcomes after LDLT.
AB - We examined the outcomes of patients who received living donor liver transplantation (LDLT) for HCC comparing the impact of up-to-seven criteria and Asan Criteria (AC) with Milan Criteria (MC). Between July 2004 and July 2009, of 175 consecutive LDLT, there were 45 consecutive patients with HCC. Forty patients who completed 12 months follow-up were enrolled. In search for the highest number of expansion, we selected AC as the extended criteria. Patients were divided into having tumors within MC, beyond MC within AC and Beyond Criteria (BC) groups. With a median follow-up of 46 months, overall 1, 3, and 5 years survival was -90%, -81%, and -70%, respectively. In patients within AC, estimated mean survival was 49.8 vs. 40.5 months for BC group (P = 0.2). Disease-free survival was significantly higher in patients within AC comparing with BC group; 48.0 vs. 38.6 months (P = 0.04). Preoperative AFP level >400 and poor tumor differentiation were factors adversely effecting recipient survival. On multivariate analysis, the presence of poor tumor differentiation (P = 0.018 RR: 2.48) was the only independent predictor of survival. Extension of tumor size and number to AC is feasible, without significantly compromising outcomes; however, the presence of poor tumor differentiation was associated with worse outcomes after LDLT.
KW - donation
KW - hepatocellular cancer
KW - living donor
KW - selection criteria
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UR - http://www.scopus.com/inward/citedby.url?scp=80053986989&partnerID=8YFLogxK
U2 - 10.1111/j.1432-2277.2011.01311.x
DO - 10.1111/j.1432-2277.2011.01311.x
M3 - Article
C2 - 21854454
AN - SCOPUS:80053986989
SN - 0934-0874
VL - 24
SP - 1075
EP - 1083
JO - Transplant International
JF - Transplant International
IS - 11
ER -