title: Liver transplantation for adenomatosis: European experience.
abstract: The aim of this study was to collect data from patients who underwent liver transplantation (LT) for adenomatosis; to analyze the symptoms, the characteristics of the disease, and the recipient outcomes; and to better define the role of LT in this rare indication. This retrospective multicenter study, based on data from the European Liver Transplant Registry, encompassed patients who underwent LT for adenomatosis between January 1, 1986, and July 15, 2013, in Europe. Patients with glycogen storage disease (GSD) type IA were not excluded. This study included 49 patients. Sixteen patients had GSD, and 7 had liver vascular abnormalities. The main indications for transplantation were either a suspicion of hepatocellular carcinoma (HCC; 15 patients) or a histologically proven HCC (16 patients), but only 17 had actual malignant transformation (MT) of adenomas. GSD status was similar for the 2 groups, except for age and the presence of HCC on explants (P = 0.030). Three patients with HCC on explant developed recurrence after transplantation. We obtained and studied the pathomolecular characteristics for 23 patients. In conclusion, LT should remain an extremely rare treatment for adenomatosis. Indications for transplantation primarily concern the MT of adenomas. The decision should rely on morphological data and histological evidence of MT. Additional indications should be discussed on a case-by-case basis. In this report, we propose a simplified approach to this decision-making process.
authors.affiliation: Chirurgie Hépatobiliaire et Pancréatique, Centre Hospitalier Universitaire Bordeaux, Maison du Haut Lévèque, Bordeaux, France.
authors.forename: Laurence
authors.initials: L
authors.lastname: Chiche
authors.affiliation: Chirurgie Hépatobiliaire et Pancréatique, Centre Hospitalier Universitaire Bordeaux, Maison du Haut Lévèque, Bordeaux, France.
authors.forename: Anaelle
authors.initials: A
authors.lastname: David
authors.affiliation: ELTR and ELITA Board. www.eltr.org.|Centre Hépato-Biliaire, INSERM U785, Hôpital Paul Brousse, Villejuif, France.
authors.forename: René
authors.initials: R
authors.lastname: Adam
authors.affiliation: Transplant Surgery Department, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.|ELTR and ELITA Board. www.eltr.org.
authors.forename: M Martin
authors.initials: MM
authors.lastname: Oliverius
authors.affiliation: Department of General, Visceral and Transplant Surgery, Hannover Medical School, Hanover, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Klempnauer
authors.affiliation: Centre Hépato-Biliaire, INSERM U785, Hôpital Paul Brousse, Villejuif, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Vibert
authors.affiliation: Department of Surgery, Ospedale Papa Giovanni XXIII, Bergamo, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Colledan
authors.affiliation: Cliniques Universitaires Saint-Luc, Brussels, Belgium.
authors.forename: Jan
authors.initials: J
authors.lastname: Lerut
authors.affiliation: Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, Istituto Nazionale Tumori IRCCS Foundation, Milan, Italy.
authors.forename: V Vincenzo
authors.initials: VV
authors.lastname: Mazzafero
authors.affiliation: Department of General Surgery and Transplantation, Niguarda Ca'Granda Hospital, Milan, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Di-Sandro
authors.affiliation: Chirurgie Hépatobiliaire et Pancréatique, Centre Hospitalier Universitaire Bordeaux, Maison du Haut Lévèque, Bordeaux, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Laurent
authors.affiliation: Department of General and Hepato-Biliary Surgery, Liver Transplantation Service, Ghent University Hospital, Ghent, Belgium.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Scuderi
authors.affiliation: Chirurgie Générale et Digestive, Hôpital de Rangueil, Centre Hospitalier Universitaire Toulouse, Toulouse, France.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Suc
authors.affiliation: Department of General and Hepato-Biliary Surgery, Liver Transplantation Service, Ghent University Hospital, Ghent, Belgium.
authors.forename: Roberto
authors.initials: R
authors.lastname: Troisi
authors.affiliation: Hôpital de Haute Pierre, Service de Chirurgie Hépatique et Transplantation, Centre Hospitalier Universitaire Strasbourg, Strasbourg, France.
authors.forename: Phillipe
authors.initials: P
authors.lastname: Bachelier
authors.affiliation: Service d'Hépato-Gastro-Entérologie, Hôpital Edouard Herriot, Centre Hospitalier Universitaire Lyon, Lyon, France.
authors.forename: Jerôme
authors.initials: J
authors.lastname: Dumortier
authors.affiliation: Service de Chirurgie Digestive et Centre de Transplantation Hépatique de l'Hôpital de l'Archet, Centre Hospitalier Universitaire Nice, Nice, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Gugenheim
authors.affiliation: Chirurgie Générale et Digestive et de la Transplantation Hépatique et Intestinale, Hôpital de la Croix-Rousse, Centre Hospitalier Universitaire Lyon, Lyon, France.
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Mabrut
authors.affiliation: General and Digestive Surgery Department, Hospital Universitario Central de Asturias, Oviedo, Spain.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Gonzalez-Pinto
authors.affiliation: Centre Hospitalier Régional Universitaire de Lille, Lille, France.
authors.forename: François-René
authors.initials: FR
authors.lastname: Pruvot
authors.affiliation: Chirurgie Générale et digestive, Hôpital de la Conception, Centre Hospitalier Universitaire Marseille, Marseille, France.
authors.forename: Yves Patrice
authors.initials: YP
authors.lastname: Le-Treut
authors.affiliation: Chirurgie Digestive, Hôpital Saint Eloi, Centre Hospitalier Universitaire Montpellier, Montpellier, France.
authors.forename: Francis
authors.initials: F
authors.lastname: Navarro
authors.affiliation: Hepato-Biliary Surgery and Liver Transplantation Unit, Hospital Universitario de Cruces, Bilbao, Spain.
authors.forename: Jorge
authors.initials: J
authors.lastname: Ortiz-de-Urbina
authors.affiliation: Chirurgie Hépato-Biliaire et Digestive, Centre Hospitalier Universitaire Tours.
authors.forename: Ephrem
authors.initials: E
authors.lastname: Salamé
authors.affiliation: Instituto Mediterraneo Trapianti e Terapie ad Alta Specializzazione, University of Pittsburgh Medical Center in Italy, Palermo, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Spada
authors.affiliation: Service de Pathologie, INSERM U1053, Université Bordeaux Segalen, Hôpital Pellegrin, Bordeaux, France.
authors.forename: Paulette
authors.initials: P
authors.lastname: Bioulac-Sage
mesh_terms: D018248:Adenoma, Liver Cell / Q000473:pathology / Q000601:surgery*; D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery*; D000066491:Clinical Decision-Making / Q000379:methods; D015331:Cohort Studies; D005060:Europe / Q000453:epidemiology; D005260:Female; D005953:Glycogen Storage Disease Type I / Q000601:surgery; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D016031:Liver Transplantation / Q000706:statistics & numerical data*; D008297:Male; D035583:Rare Diseases / Q000601:surgery*; D012042:Registries / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016896:Treatment Outcome