Faculty Collaboration Database

Role of transplantation in the treatment of benign solid tumors of the liver: a review of the United Network of Organ Sharing data set. JAMA Surg 2015 Apr;150(4):337-42

Date

02/26/2015

Pubmed ID

25714928

DOI

10.1001/jamasurg.2014.3166

Scopus ID

2-s2.0-84928141061 (requires institutional sign-in at Scopus site)   18 Citations

Abstract

IMPORTANCE: The role of orthotopic liver transplantation for the treatment of benign solid liver tumors (BSLT) is not well defined.

OBJECTIVE: To analyze outcomes in the United Network of Organ Sharing data set of patients with a diagnosis of BSLT who underwent transplantation.

DESIGN, SETTING, AND PARTICIPANTS: A retrospective analysis of the United Network of Organ Sharing data set was performed for all (N = 87,280) patients who underwent transplantation for BSLT in the United States from October 1, 1988, through January 31, 2013.

MAIN OUTCOMES AND MEASURES: Demographics, clinicopathological characteristics, distribution of the procedures by region and state, and overall survival rates.

RESULTS: During the study period, 147 liver transplants (0.17%) were to treat BSLT. Sixty-two patients (42.2%) had adenomas, 29 (19.7%) had focal nodular hyperplasia, 25 (17.0%) had hemangiomas, 11 (7.5%) had hepatic epithelioid hemangioendotheliomas, and 20 (13.6%) were classified as having unknown benign tumors. The overall 1-, 3-, and 5-year survival rates were 90.9%, 85.2%, and 81.8%, respectively. Using multivariable analysis, we found that age was the only independent factor associated with patient survival. The overall 5-year survival rate for patients older than 50 years was 88% compared with 91% in younger individuals (95% CI, 148-384; P = .005). Region 3 (Alabama, Arkansas, Florida, Georgia, Louisiana, Mississippi, and Puerto Rico) contributed the maximum number (33 [22.4%]) of these transplants.

CONCLUSIONS AND RELEVANCE: Although liver transplantation cannot be considered a first-line treatment, it is a valid therapeutic option in selected patients who are not amenable to resection. Only 0.17% of the transplants in the United States are performed for this indication, with satisfying long-term results. Age was an independent predictor of patient survival. Further studies are needed to better understand the role of liver transplantation in the treatment of BSLT.

Author List

Sundar Alagusundaramoorthy S, Vilchez V, Zanni A, Sourianarayanane A, Maynard E, Shah M, Daily MF, Pena LR, Gedaly R

Author

Achuthan Sourianarayanane MD Associate Professor in the Medicine department at Medical College of Wisconsin

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

Adult
Databases, Factual
Female
Humans
Liver Diseases
Liver Function Tests
Liver Transplantation
Male
Patient Selection
Survival Rate
United States