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Living-Donor Liver Transplantation Associated With Higher Incidence of Hepatocellular Carcinoma Recurrence Than Deceased-Donor Liver Transplantation

Title
Living-Donor Liver Transplantation Associated With Higher Incidence of Hepatocellular Carcinoma Recurrence Than Deceased-Donor Liver Transplantation
Authors
Park, Min-SuLee, Kwang-WoongSuh, Suk-WonYou, TaeChoi, YoungRokKim, HyeyoungHong, GeunYi, Nam-JoonKwon, Choon-Hyuck DavidJoh, Jae-WonLee, Suk-KooSuh, Kyung-Suk
Ewha Authors
홍근
SCOPUS Author ID
홍근scopus
Issue Date
2014
Journal Title
TRANSPLANTATION
ISSN
0041-1337JCR Link

1534-6080JCR Link
Citation
TRANSPLANTATION vol. 97, no. 1, pp. 71 - 77
Keywords
Deceased-donor liver transplantationHepatocellular carcinomaLiving-donor liver transplantationRecurrence
Publisher
LIPPINCOTT WILLIAMS &

WILKINS
Indexed
SCIE; SCOPUS WOS
Document Type
Article
Abstract
Background Living-donor liver transplantation (LDLT) is becoming an important tool in hepatocellular carcinoma (HCC) treatment. However, the oncologic outcome between LDLT and deceased-donor LT (DDLT) for HCC remains controversial. This study aims to compare the HCC recurrence rates after LDLT versus DDLT. Methods Two hundred sixteen patients (166 LDLTs and 50 DDLTs) who underwent LT for HCC within University of California-San Francisco criteria were retrospectively reviewed. LDLT patients were divided into two groups: small living-donor graft (LDG; graft-to-recipient body weight ratio<1.0, n=59) and nonsmall LDG (graft-to-recipient body weight ratio1.0, n=107). Patients were further stratified into low- and high-risk settings by the number of risk factors for recurrence. Results The recurrence-free survival was lower in LDLT compared with DDLT (88.6% and 80.7% vs. 96.0% and 94.0% at 1 and 5 years; P=0.045). There was no significant difference between two groups regarding the majority of clinical and tumor characteristics, with the exception of a higher proportion of microvascular invasion presence in LDLT. After the adjustment for microvascular invasion, LDLT was identified as an independent risk factor for recurrence. Moreover, recurrence-free survival between small and nonsmall LDG was not statistically significant. In low-risk setting (1 risk factor), LDLT showed comparable outcome with DDLT. However, the risk of recurrence was higher in LDLT than DDLT in high-risk patients. Conclusion In conclusion, LDLT showed poorer outcome than DDLT. This should be considered to select optimal strategy for HCC.
DOI
10.1097/TP.0b013e3182a68953
Appears in Collections:
의과대학 > 의학과 > Journal papers
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