title: Liver transplantation for fibrolamellar hepatocellular carcinoma: A national perspective.
abstract: BACKGROUND
  Fibrolamellar Hepatocellular Carcinoma (FL-HCC) is a rare primary liver tumor that usually presents in younger patients without underlying liver disease.
  
  
  METHODS
  We queried the United Network of Organ Sharing (UNOS) database between October 1988 and January 2013 to evaluate outcomes in patients with FL-HCC undergoing liver transplantation in the United States compared to patients with conventional Hepatocellular Carcinoma (HCC).
  
  
  RESULTS
  Sixty-three patients were identified (57% female, mean age 30 years). Only one patient (2%) had an associated Hepatitis C Virus. Mean Model for End-Stage Liver Disease (MELD) score at the time of transplantation was 11.3. Mean waiting time was 325 days and mean cold ischemic time was 6 hr. Overall survival of FL-HCC patients at 1, 3, and 5 years was 96%, 80%, and 48% as compared to HCC patients whose rates were 89%, 77%, and 68%. Six patients had tumor recurrence (10%). The Cox Model demonstrated that MELD and cold ischemic time are the strongest predictors of overall survival in FL-HCC patients. Age and wait time were not associated with poor patient survival in this series.
  
  
  CONCLUSIONS
  Good results can be obtained in selected patients transplanted for FL-HCC. FL-HCC patients had similar survival compared to those transplanted for HCC. J. Surg. Oncol. 2017;115:319-323. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Division of Transplant, Department of Surgery, University of Kentucky, College of Medicine, Lexington, Kentucky.
authors.forename: Leonardo Garcia
authors.initials: LG
authors.lastname: Atienza
authors.affiliation: Division of Transplant, Department of Surgery, University of Kentucky, College of Medicine, Lexington, Kentucky.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Berger
authors.affiliation: Division of Transplant, Department of Surgery, University of Kentucky, College of Medicine, Lexington, Kentucky.
authors.forename: Xiaonan
authors.initials: X
authors.lastname: Mei
authors.affiliation: Division of Transplant, Department of Surgery, University of Kentucky, College of Medicine, Lexington, Kentucky.
authors.forename: Malay B
authors.initials: MB
authors.lastname: Shah
authors.affiliation: Division of Transplant, Department of Surgery, University of Kentucky, College of Medicine, Lexington, Kentucky.
authors.forename: Michael F
authors.initials: MF
authors.lastname: Daily
authors.affiliation: Division of Hepatology, Department of Internal Medicine, University of Kentucky, College of Medicine, Lexington, Kentucky.
authors.forename: Alla
authors.initials: A
authors.lastname: Grigorian
authors.affiliation: Division of Transplant, Department of Surgery, University of Kentucky, College of Medicine, Lexington, Kentucky.
authors.forename: Roberto
authors.initials: R
authors.lastname: Gedaly
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008113:Liver Neoplasms / Q000453:epidemiology / Q000601:surgery*; D016031:Liver Transplantation / Q000379:methods / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: fibrolamellar; fibrolamellar hepatocellular carcinoma; liver transplantation