Living donor liver transplantation for hepatocellular carcinoma: a single-center preliminary report.
Liver transplantation (LT) is the treatment of choice for early hepatocellular carcinoma (HCC) in patients with end-stage liver disease but is limited by the availability of donor organs. Living donor liver transplantation (LDLT) represents an alternative therapeutic option for patients with disease confined to the liver. Between April 1998 and December 2003, 537 patients underwent liver transplantation in our center. Thirty patients with HCC and associated terminal cirrhosis and 4 patients with tumor recurrence after liver resection who underwent LDLT were reviewed. Nineteen patients (55.8%) met the Milan criteria for LT, whereas 15 patients (44.2%) "exceeded" them. The overall survival rates at 1 and 2 years were 68% and 62%, respectively, with a median follow-up of 41 months (range, 17-64 months). Five patients (14.7%) died in the first 30 days after LDLT. Hospital mortality was significantly correlated with age > 60 years. Four patients developed recurrence between 6 and 35 months after LDLT. Recurrence was significantly related to the presence of more than 3 tumor lesions in our series. In conclusion, LDLT is a promising treatment option for patients with HCC. Even longer follow-up and bigger patients' series are needed to fully assess the benefits of LDLT for HCC patients exceeding the Milan criteria.
Malagó
Massimo
M
Department of General Surgery and Transplantation, University Hospital Essen, Essen, Germany. massimo.malago@uni-essen.de
Sotiropoulos
Georgios C
GC
Nadalin
Silvio
S
Valentin-Gamazo
Camino
C
Paul
Andreas
A
Lang
Hauke
H
Radtke
Arnold
A
Saner
Fuat
F
Molmenti
Ernesto
E
Beckebaum
Susanne
S
Gerken
Guido
G
Frilling
Andrea
A
Broelsch
Christoph E
CE
D000293:Adolescent; D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery*; D016031:Liver Transplantation; D019520:Living Donors; D008875:Middle Aged