Section 4. Further expanding the criteria for HCC in living donor liver transplantation: the Tokyo University experience.
In Asia, evidence-based guidelines for the management of hepatocellular carcinoma (HCC) have evolved, including the option of liver transplantation. Because of the continuing serious organ shortage, however, living donor liver transplantation (LDLT) remains the mainstream in Japan. Unlike deceased donor transplantation, living donor transplantation is not always limited by the restrictions imposed by the nationwide organ allocation system. The decision for transplantation may depend on institutional or case-by-case considerations, balancing the will of the donor, the operative risk, and the overall survival benefit. Cumulative data from the Japanese national multicenter registry analysis as well as individual center experiences suggest further expanding the criteria for LDLT for HCC from the Milan criteria is feasible with acceptable outcomes.
1 Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, the University of Tokyo and Organ Transplantation Service, the University of Tokyo Hospital. 2 Address correspondence to: Yasuhiko Sugawara, Artificial Organ and Transplantation Division, Hepato-Biliary and Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
Sumihito
S
Tamura
Yasuhiko
Y
Sugawara
Norihiro
N
Kokudo
D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D003661:Decision Support Techniques; D018572:Disease-Free Survival; D006785:Hospitals, University; D006801:Humans; D007564:Japan; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D019520:Living Donors; D009364:Neoplasm Recurrence, Local; D018579:Patient Selection; D011237:Predictive Value of Tests; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome