Pilot study of living donor liver transplantation for patients with HCC exceeding Milan criteria

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...

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Autores: Llovet i Bayer, Josep Maria, Pavel, Mihai, Rimola Gibert, Jordi, Diaz, Maria Alba, Colmenero, Jordi, Saavedra Pérez, David, Fondevila Campo, Constantino, Ayuso Colella, Carmen, Fuster Obregón, Josep, Ginès i Gibert, Pere, Bruix Tudó, Jordi, García-Valdecasas Salgado, Juan Carlos
Tipo de recurso: artículo
Estado:Versión aceptada para publicación
Fecha de publicación:2017
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/119018
Acceso en línea:https://hdl.handle.net/2445/119018
Access Level:acceso abierto
Palabra clave:Trasplantament hepàtic
Pronòstic mèdic
Càncer de fetge
Hepatic transplantation
Prognosis
Liver cancer
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spelling Pilot study of living donor liver transplantation for patients with HCC exceeding Milan criteriaLlovet i Bayer, Josep MariaPavel, MihaiRimola Gibert, JordiDiaz, Maria AlbaColmenero, JordiSaavedra Pérez, DavidFondevila Campo, ConstantinoAyuso Colella, CarmenFuster Obregón, JosepGinès i Gibert, PereBruix Tudó, JordiGarcía-Valdecasas Salgado, Juan CarlosTrasplantament hepàticPronòstic mèdicCàncer de fetgeHepatic transplantationPrognosisLiver cancerBACKGROUND & 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 tNo longer published by Elsevier2017info:eu-repo/semantics/articleinfo:eu-repo/semantics/acceptedVersionapplication/pdfhttps://hdl.handle.net/2445/119018Articles publicats en revistes (Cirurgia i Especialitats Medicoquirúrgiques)reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésVersió postprint del document publicat a: https://doi.org/10.1002/lt.24977Liver Transplantation, 2017https://doi.org/10.1002/lt.24977(c) American Association for the Study of Liver Diseases, 2017info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/1190182026-05-27T06:46:51Z
dc.title.none.fl_str_mv Pilot study of living donor liver transplantation for patients with HCC exceeding Milan criteria
title Pilot study of living donor liver transplantation for patients with HCC exceeding Milan criteria
spellingShingle Pilot study of living donor liver transplantation for patients with HCC exceeding Milan criteria
Llovet i Bayer, Josep Maria
Trasplantament hepàtic
Pronòstic mèdic
Càncer de fetge
Hepatic transplantation
Prognosis
Liver cancer
title_short Pilot study of living donor liver transplantation for patients with HCC exceeding Milan criteria
title_full Pilot study of living donor liver transplantation for patients with HCC exceeding Milan criteria
title_fullStr Pilot study of living donor liver transplantation for patients with HCC exceeding Milan criteria
title_full_unstemmed Pilot study of living donor liver transplantation for patients with HCC exceeding Milan criteria
title_sort Pilot study of living donor liver transplantation for patients with HCC exceeding Milan criteria
dc.creator.none.fl_str_mv Llovet i Bayer, Josep Maria
Pavel, Mihai
Rimola Gibert, Jordi
Diaz, Maria Alba
Colmenero, Jordi
Saavedra Pérez, David
Fondevila Campo, Constantino
Ayuso Colella, Carmen
Fuster Obregón, Josep
Ginès i Gibert, Pere
Bruix Tudó, Jordi
García-Valdecasas Salgado, Juan Carlos
author Llovet i Bayer, Josep Maria
author_facet Llovet i Bayer, Josep Maria
Pavel, Mihai
Rimola Gibert, Jordi
Diaz, Maria Alba
Colmenero, Jordi
Saavedra Pérez, David
Fondevila Campo, Constantino
Ayuso Colella, Carmen
Fuster Obregón, Josep
Ginès i Gibert, Pere
Bruix Tudó, Jordi
García-Valdecasas Salgado, Juan Carlos
author_role author
author2 Pavel, Mihai
Rimola Gibert, Jordi
Diaz, Maria Alba
Colmenero, Jordi
Saavedra Pérez, David
Fondevila Campo, Constantino
Ayuso Colella, Carmen
Fuster Obregón, Josep
Ginès i Gibert, Pere
Bruix Tudó, Jordi
García-Valdecasas Salgado, Juan Carlos
author2_role author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Trasplantament hepàtic
Pronòstic mèdic
Càncer de fetge
Hepatic transplantation
Prognosis
Liver cancer
topic Trasplantament hepàtic
Pronòstic mèdic
Càncer de fetge
Hepatic transplantation
Prognosis
Liver cancer
description 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
publishDate 2017
dc.date.none.fl_str_mv 2017
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/acceptedVersion
format article
status_str acceptedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/119018
url https://hdl.handle.net/2445/119018
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Versió postprint del document publicat a: https://doi.org/10.1002/lt.24977
Liver Transplantation, 2017
https://doi.org/10.1002/lt.24977
dc.rights.none.fl_str_mv (c) American Association for the Study of Liver Diseases, 2017
info:eu-repo/semantics/openAccess
rights_invalid_str_mv (c) American Association for the Study of Liver Diseases, 2017
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv No longer published by Elsevier
publisher.none.fl_str_mv No longer published by Elsevier
dc.source.none.fl_str_mv Articles publicats en revistes (Cirurgia i Especialitats Medicoquirúrgiques)
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.300719

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