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Optimal Tailored Screening Protocol after Living Donor Liver Transplantation for Hepatocellular Carcinoma

Title
Optimal Tailored Screening Protocol after Living Donor Liver Transplantation for Hepatocellular Carcinoma
Authors
Park, Min-SuLee, Kwang-WoongYi, Nam-JoonChoi, Young RokKim, HyeyoungHong, GeunSuh, Kyung-SukKwon, Choon-Hyuck DavidJoh, Jae-WonLee, Suk-Koo
Ewha Authors
홍근
SCOPUS Author ID
홍근scopus
Issue Date
2014
Journal Title
JOURNAL OF KOREAN MEDICAL SCIENCE
ISSN
1011-8934JCR Link

1598-6357JCR Link
Citation
JOURNAL OF KOREAN MEDICAL SCIENCE vol. 29, no. 10, pp. 1360 - 1366
Keywords
CarcinomaHepatocellularLiving DonorsLiver TransplantationRecurrenceScreening
Publisher
KOREAN ACAD MEDICAL SCIENCES
Indexed
SCIE; SCOPUS; KCI WOS
Document Type
Article
Abstract
The indication for hepatocellular carcinoma (HCC) is expanding in living donor liver transplantation (LDLT). Early detection and effective management of recurrence has become an important issue in LDLT for HCC. This study aimed to find an optimal screening protocol in terms of screening interval and screening tools by analyzing recurrence pattern after LDLT for HCC. A total of 205 LDLT patients in two centers from February 1999 to October 2010 was reviewed. Recurrence appeared in 55 cases. Six risk factors for recurrence were identified: preoperative alpha-fetoprotein > 400, Edmonson grade 3 or 4, tumor size > 7 cm, tumor number >= 7, minimal tumor necrosis in the transarterial chemoembolization group and positive micro-vascular invasion. Four groups with different ranges of index scores showed different recurrence-free survival and median time to recurrence. Group I showed low and late recurrence. Groups II and III showed linearly increased rate of recurrence until 18 months. Group IV showed very early recurrence within 6 months. Across the groups, extra-hepatic recurrence developed in more than 40% of cases and multi-organ recurrence rate was 20%. The screening interval should be different based on the risk of recurrence. Screening should include work-up for extra-hepatic recurrence as well as intra-hepatic recurrence.
DOI
10.3346/jkms.2014.29.10.1360
Appears in Collections:
의과대학 > 의학과 > Journal papers
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