title: Living donor liver transplantation for hepatocellular carcinoma: long-term results compared with deceased donor liver transplantation.
abstract: OBJECTIVE
  Living donor liver transplantation (LDLT) may represent a valid therapeutic option allowing several advantages for patients affected by hepatocellular carcinoma (HCC) awaiting orthotopic liver transplantation (OLT). However, some reports in the literature have demonstrated worse long-term and disease-free survivals among patients treated by LDLT than deceased donor liver transplantation (DDLT) for HCC. Herein we have reported our long-term results comparing LDLT with DDLT for HCC.
  
  
  METHODS
  Among 179 patients who underwent OLT from January 2000 to December 2007, 25 (13.9%) received LDLT with HCC 154 (86.1%) received DDLT. Patients were selected based on the Milan criteria. Transarterial chemoembolization, radiofrequency ablation, percutaneous alcoholization, or liver resection was applied as a downstaging procedure while on the waiting list. Patients with stage II HCC were proposed for LDLT.
  
  
  RESULTS
  The overall 3- and 5-year survival rates were 77.3% and 68.7% versus 82.8% and 76.7% for LDLT and DDLT recipients, respectively, with no significant difference by the log-rank test. Moreover, the 3- and 5-year recurrence-free survival rates were 95.5% and 95.5% (LDLT) versus 90.5% and 89.4% (DDLT; P = NS).
  
  
  CONCLUSIONS
  LDLT guarantees the same long-term results as DDLT where there are analogous selection criteria for candidates. The Milan criteria remain a valid tool to select candidates for LDLT to achieve optimal long-term results.
authors.affiliation: Department of Surgery and Abdominal Transplantation, Niguarda Ca' Granda Hospital, Milan, Italy. stefano.disandro@ospedaleniguarda.it
authors.forename: S
authors.initials: S
authors.lastname: Di Sandro
authors.forename: A O
authors.initials: AO
authors.lastname: Slim
authors.forename: A
authors.initials: A
authors.lastname: Giacomoni
authors.forename: A
authors.initials: A
authors.lastname: Lauterio
authors.forename: I
authors.initials: I
authors.lastname: Mangoni
authors.forename: P
authors.initials: P
authors.lastname: Aseni
authors.forename: V
authors.initials: V
authors.lastname: Pirotta
authors.forename: A
authors.initials: A
authors.lastname: Aldumour
authors.forename: P
authors.initials: P
authors.lastname: Mihaylov
authors.forename: L
authors.initials: L
authors.lastname: De Carlis
mesh_terms: D002102:Cadaver; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery*; D016031:Liver Transplantation; D019520:Living Donors; D015996:Survival Rate