title: The Use of Donation After Cardiac Death Allografts Does Not Increase Recurrence of Hepatocellular Carcinoma.
abstract: Hepatocellular carcinoma (HCC) recurrence in patients undergoing liver transplantation (LT) with donation after brain death (DBD) and donation after cardiac death (DCD) allografts has not previously been investigated. Rates and patterns of HCC recurrences were investigated in patients undergoing DBD (N = 1633) and DCD (N = 243) LT between 2003 and 2012. LT for HCC was identified in 397 patients (340 DBD and 57 DCD). No difference in tumor number (p = 0.26), tumor volume (p = 0.34) and serum alphafetoprotein (AFP) (p = 0.47) was seen between the groups. HCC recurrence was identified in 41 (12.1%) patients in the DBD group and 7 (12.3%) patients in the DCD group. There was no difference in recurrence-free survival (p = 0.29) or cumulative incidence of HCC recurrence (p = 0.91) between the groups. Liver allograft was the first site of recurrence in 22 (65%) patients in the DBD group and two (37%) patients in the DCD group (p = 0.39). LT for HCC with DBD and DCD allografts demonstrate no difference in the rate of HCC recurrence. Previously published differences in survival demonstrated between recipients with HCC receiving DBD and DCD allografts despite statistical adjustment can likely be explained by practice patterns not captured by variables contained in the SRTR database.
authors.affiliation: Department of Transplantation, Mayo Clinic Florida, Jacksonville, FL.
authors.forename: K P
authors.initials: KP
authors.lastname: Croome
authors.affiliation: Department of Transplantation, Mayo Clinic Florida, Jacksonville, FL.
authors.forename: D D
authors.initials: DD
authors.lastname: Lee
authors.affiliation: Department of Transplantation, Mayo Clinic Florida, Jacksonville, FL.
authors.forename: J M
authors.initials: JM
authors.lastname: Burns
authors.forename: K
authors.initials: K
authors.lastname: Musto
authors.affiliation: Department of Transplantation, Mayo Clinic Florida, Jacksonville, FL.
authors.forename: D
authors.initials: D
authors.lastname: Paz
authors.affiliation: Department of Transplantation, Mayo Clinic Florida, Jacksonville, FL.
authors.forename: J H
authors.initials: JH
authors.lastname: Nguyen
authors.affiliation: Department of Transplantation, Mayo Clinic Florida, Jacksonville, FL.
authors.forename: D K
authors.initials: DK
authors.lastname: Perry
authors.affiliation: Department of Transplantation, Mayo Clinic Florida, Jacksonville, FL.
authors.forename: D M
authors.initials: DM
authors.lastname: Harnois
authors.affiliation: Department of Transplantation, Mayo Clinic Florida, Jacksonville, FL.
authors.forename: C B
authors.initials: CB
authors.lastname: Taner
mesh_terms: D000328:Adult; D000368:Aged; D064591:Allografts / Q000637:transplantation; D001926:Brain Death; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000601:surgery*; D003643:Death; D046148:Donor Selection; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000601:surgery*; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000209:etiology*; D012189:Retrospective Studies; D016019:Survival Analysis; D014019:Tissue Donors; D014184:Transplantation, Homologous / Q000379:methods; D016896:Treatment Outcome
keywords: Donors and donation: donation after brain death (DBD); donors and donation: donation after circulatory death (DCD); liver disease: malignant, ischemia reperfusion injury (IRI)