Background/Aims: LDLT may represent a valid therapeutic option allowing several advantages for patients affected by HCC and waiting for liver transplantation (LT). However, some reports show a worse long term survival and disease free survival among patients treated by LDLT for HCC than deceased donor liver transplantation (DDLT) recipients. Methodology: Among 1145 LT patients, 63 received LDLT. From January 2000 to December 2008, 179 patients underwent LT due to HCC, 30 (16.7%) received LDLT and 154 (86.0%) received DDLT. Patients were selected based on the Milan criteria. TACE, radiofrequency ablation, percutaneous alcoholization, or liver resection were applied as downstaging procedures, while on the waiting list. Results: Overall 3- and 5-year survival rate was 77.3% and 68.7% vs. 82.8% and 76.7%, respectively for LDLT and DDLT recipient with not significant differences. Moreover, 3- and 5- years of recurrence free survival rate was 95.5% (LDLT) vs. 90.5% and 89.4% (DDLT) and resulted not significantly different. Conclusions: LDLT guarantees same long term results than DDLT if the selection criteria of candidates are analogues. Milan criteria remains a valid candidate selection tool to obtain optimal long term results in LDLT. An aggressive downstaging policy seems to improve the long-term results in LDLT, thus LRT may be considered useful to prevent tumor progression waiting for transplantation as well as a neoadjuvant therapy for HCC. A literature detailed meta-analysis could definitely clarify if LDLT is an independent risk factor for HCC recurrence. © H.G.E. Update Medical Publishing S.A.

Di Sandro, S., Giacomoni, A., Slim, A., Lauterio, A., Mangoni, I., Mihaylov, P., et al. (2012). Living donor liver transplantation for hepatocellular carcinoma: The impact of neo-adjuvant treatments on the long term results. HEPATO-GASTROENTEROLOGY, 59(114), 505-510 [10.5754/hge11225].

Living donor liver transplantation for hepatocellular carcinoma: The impact of neo-adjuvant treatments on the long term results

Lauterio, A;DE CARLIS, LUCIANO GREGORIO
Ultimo
2012

Abstract

Background/Aims: LDLT may represent a valid therapeutic option allowing several advantages for patients affected by HCC and waiting for liver transplantation (LT). However, some reports show a worse long term survival and disease free survival among patients treated by LDLT for HCC than deceased donor liver transplantation (DDLT) recipients. Methodology: Among 1145 LT patients, 63 received LDLT. From January 2000 to December 2008, 179 patients underwent LT due to HCC, 30 (16.7%) received LDLT and 154 (86.0%) received DDLT. Patients were selected based on the Milan criteria. TACE, radiofrequency ablation, percutaneous alcoholization, or liver resection were applied as downstaging procedures, while on the waiting list. Results: Overall 3- and 5-year survival rate was 77.3% and 68.7% vs. 82.8% and 76.7%, respectively for LDLT and DDLT recipient with not significant differences. Moreover, 3- and 5- years of recurrence free survival rate was 95.5% (LDLT) vs. 90.5% and 89.4% (DDLT) and resulted not significantly different. Conclusions: LDLT guarantees same long term results than DDLT if the selection criteria of candidates are analogues. Milan criteria remains a valid candidate selection tool to obtain optimal long term results in LDLT. An aggressive downstaging policy seems to improve the long-term results in LDLT, thus LRT may be considered useful to prevent tumor progression waiting for transplantation as well as a neoadjuvant therapy for HCC. A literature detailed meta-analysis could definitely clarify if LDLT is an independent risk factor for HCC recurrence. © H.G.E. Update Medical Publishing S.A.
Articolo in rivista - Articolo scientifico
Hepatocellular carcinoma; Living donor liver transplantation; Pre-transplant treatments; Carcinoma, Hepatocellular; Chi-Square Distribution; Disease-Free Survival; Humans; Kaplan-Meier Estimate; Liver Neoplasms; Logistic Models; Lung Neoplasms; Neoplasm Recurrence, Local; Neoplasm Staging; Survival Rate; Time Factors; Treatment Outcome; Waiting Lists; Hepatectomy; Living Donors; Neoadjuvant Therapy; Gastroenterology; Hepatology
English
2012
59
114
505
510
none
Di Sandro, S., Giacomoni, A., Slim, A., Lauterio, A., Mangoni, I., Mihaylov, P., et al. (2012). Living donor liver transplantation for hepatocellular carcinoma: The impact of neo-adjuvant treatments on the long term results. HEPATO-GASTROENTEROLOGY, 59(114), 505-510 [10.5754/hge11225].
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/101043
Citazioni
  • Scopus 5
  • ???jsp.display-item.citation.isi??? 3
Social impact