title: Living donor liver transplantation for hepatocellular carcinoma: Increased recurrence but improved survival.
abstract: In regions with a limited deceased donor pool, living donor adult liver transplantation (LDALT) has become an important treatment modality for patients with hepatocellular carcinoma (HCC) and cirrhosis. Studies have shown higher recurrence rates of HCC after LDALT in comparison with deceased donor liver transplantation (DDLT). The aim of our study was to examine the outcome results and recurrence rates for patients with HCC who underwent LDALT at our center. During an 8-year period, 139 patients underwent LDALT, of whom 28 (20.1%) had HCC in their explanted livers. The median follow-up was 40.8 months. The mean explant tumor size was 3.3 +/- 1.2, and the mean number of tumors was 1.5 +/- 0.8. Twenty-one patients (75%) had tumors within the Milan criteria, 5 patients had tumors outside the Milan criteria but within the University of California San Francisco (UCSF) criteria, and 2 patients were beyond the UCSF criteria. The overall 1- and 5-year patient and graft survival rates were 96% and 81%, respectively. Survival following LDALT was significantly better than survival following DDLT for HCC during the same time period (P = 0.02). Eight patients (28.6%) developed tumor recurrence. Poor differentiation of tumor cells was the most significant determinant of recurrence. Despite high recurrence rates of HCC following LDALT, overall 5-year survival appears to be excellent.
authors: Department of Transplantation, Lahey Clinic Medical Center, Burlington, MA 01805, USA.
authors: Khashayar
authors: K
authors: Vakili
authors: James J
authors: JJ
authors: Pomposelli
authors: Yee Lee
authors: YL
authors: Cheah
authors: Mohamed
authors: M
authors: Akoad
authors: W David
authors: WD
authors: Lewis
authors: Urmila
authors: U
authors: Khettry
authors: Fredric
authors: F
authors: Gordon
authors: Khalid
authors: K
authors: Khwaja
authors: Roger
authors: R
authors: Jenkins
authors: Elizabeth A
authors: EA
authors: Pomfret
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D002454:Cell Differentiation; D005260:Female; D006085:Graft Survival; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects / Q000401:mortality*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012008:Recurrence; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome