Faculty Collaboration Database

Outcomes of living and deceased donor liver transplant recipients with hepatocellular carcinoma: results of the A2ALL cohort. Am J Transplant 2012 Nov;12(11):2997-3007

Date

09/22/2012

Pubmed ID

22994906

Pubmed Central ID

PMC3523685

DOI

10.1111/j.1600-6143.2012.04272.x

Scopus ID

2-s2.0-84868198305 (requires institutional sign-in at Scopus site)   115 Citations

Abstract

Hepatocellular carcinoma (HCC) represents an increasing fraction of liver transplant indications; the role of living donor liver transplant (LDLT) remains unclear. In the Adult-to-Adult Living Donor Liver Transplantation Cohort Study, patients with HCC and an LDLT or deceased donor liver transplant (DDLT) for which at least one potential living donor had been evaluated were compared for recurrence and posttransplant mortality rates. Mortality from date of evaluation of each recipient's first potential living donor was also analyzed. Unadjusted 5-year HCC recurrence was significantly higher after LDLT (38%) than DDLT (11%), (p = 0.0004). After adjustment for tumor characteristics, HCC recurrence remained significantly different between LDLT and DDLT recipients (hazard ratio (HR) = 2.35; p = 0.04) for the overall cohort but not for recipients transplanted following the introduction of MELD prioritization. Five-year posttransplant survival was similar in LDLT and DDLT recipients from time of transplant (HR = 1.32; p = 0.27) and from date of LDLT evaluation (HR = 0.73; p = 0.36). We conclude that the higher recurrence observed after LDLT is likely due to differences in tumor characteristics, pretransplant HCC management and waiting time.

Author List

Kulik LM, Fisher RA, Rodrigo DR, Brown RS Jr, Freise CE, Shaked A, Everhart JE, Everson GT, Hong JC, Hayashi PH, Berg CL, Lok AS, A2ALL Study Group

MESH terms used to index this publication - Major topics in bold

Adult
Cadaver
Carcinoma, Hepatocellular
Cohort Studies
Female
Follow-Up Studies
Graft Rejection
Graft Survival
Humans
Kaplan-Meier Estimate
Liver Neoplasms
Liver Transplantation
Living Donors
Male
Middle Aged
Multivariate Analysis
Neoplasm Invasiveness
Neoplasm Recurrence, Local
Neoplasm Staging
Postoperative Complications
Predictive Value of Tests
Proportional Hazards Models
Retrospective Studies
Risk Assessment
Survival Rate
Time Factors
Treatment Outcome