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http://hdl.handle.net/2445/119018
Title: | Pilot study of living donor liver transplantation for patients with HCC exceeding Milan criteria |
Author: | Llovet i Bayer, Josep Maria Pavel, Mihai Rimola, Jordi Diaz, Maria Alba Colmenero, Jordi Saavedra, David Fondevila Campo, Constantino Ayuso Colella, Carmen Fuster Obregón, Josep Ginès i Gibert, Pere Bruix Tudó, Jordi García-Valdecasas Salgado, Juan Carlos |
Keywords: | Trasplantament hepàtic Pronòstic mèdic Càncer de fetge Hepatic transplantation Prognosis Liver cancer |
Issue Date: | 15-Nov-2017 |
Publisher: | No longer published by Elsevier |
Abstract: | BACKGROUND & AIMS: A subset of patients with hepatocellular carcinoma (HCC) beyond Milan criteria might obtain acceptable survival outcomes after liver transplantation. Living donor liver transplantation (LDLT) has emerged as a feasible alternative to overcome the paucity of donors. METHODS: In 2001 we started a protocol for LDLT in Child A-B patients with HCC fulfilling a set of criteria - the BCLC expanded criteria- that expanded the conventional indications of transplantation: 1 tumor ≤ 7cm, 5 tumors ≤ 3cm, 3 tumors ≤ 5cm without macrovascular invasion or down-staging to Milan after loco-regional therapies. RESULTS: We present a prospective cohort of 22 patients with BCLC extended indications based on size/number (17) or down-staging (5) treated with LDLT between 2001 and 2014. Characteristics of the patients were as follows: median age: 57yr old; males/female: 20/2, Child-Pugh A/B: 16/6, AFP <100ng/mL: 21. Twelve patients received neo-adjuvant loco-regional therapies. At the time of transplantation, 12 patients had HCC staging beyond Milan criteria and 10 within. Pathological reports showed that 50% exceeded BCLC expanded criteria. Perioperative mortality was 0%. After a median follow up of 81 months, the 1-, 3-, 5- and 10-year survival was 95.5%, 86.4%, 80.2% and 66.8%, respectively. Overall, seven patients recurred (range 9-108 mo), and the 5-y and 10-yr actuarial recurrence rate was of 23.8% and 44,4%, respectively. CONCLUSION: A proper selection of candidates for extended indications of living donor liver transplantation for HCC patients provide survival outcomes comparable t |
Note: | Versió postprint del document publicat a: https://doi.org/10.1002/lt.24977 |
It is part of: | Liver Transplantation, 2017 |
URI: | http://hdl.handle.net/2445/119018 |
Related resource: | https://doi.org/10.1002/lt.24977 |
ISSN: | 1527-6465 |
Appears in Collections: | Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer) Articles publicats en revistes (Cirurgia i Especialitats Medicoquirúrgiques) |
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File | Description | Size | Format | |
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675304.pdf | 1.36 MB | Adobe PDF | View/Open |
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