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Article: Value of live donor liver transplantation experience in major hepatectomy for hepatocellular carcinoma

TitleValue of live donor liver transplantation experience in major hepatectomy for hepatocellular carcinoma
Authors
Issue Date2003
PublisherAmerican Medical Association. The Journal's web site is located at http://www.archsurg.com
Citation
Archives Of Surgery, 2003, v. 138 n. 3, p. 265-271 How to Cite?
AbstractBackground: Live donor liver transplantation (LDLT) mandates conversance in liver anatomy and major hepatectomy. Hepatocellular carcinoma is most reliably treated by hepatectomy. Hypothesis: The outcomes of major hepatectomy for hepatocellular carcinoma are influenced by the surgeon's LDLT experience. Design: We collected prospective cohort study data on patient and disease characteristics. Setting: Tertiary referral center. Patients: A retrospective study was performed on 250 patients who underwent major hepatectomy for hepatocellular carcinoma from January 16, 1996, through December 28, 2001. Main Outcome Measures: Overall and disease-free survival and outcomes including blood loss, blood transfusion, and complications. Results: The 3 liver transplantation surgeons (LTSs) performed 102 major hepatectomies; the 4 hepatobiliary and pancreatic surgeons (HBPSs), 148 major hepatectomics. Patients in both groups had similar baseline characteristics. The mean±SD blood loss in the LTS and HBPS groups was 1.36±1.37 and 2.21±2.40 L, respectively (P<.001). The mean±SD blood transfusion in the LTS and HBPS groups was 0.27±0.82 and 0.51±0.94 L, respectively (P=.001). Fewer patients in the LTS group required blood transfusion (17/102 [16.7%]; HBPS group, 57/148 [38:5%]; P<.001). We found no difference in overall and disease-free survival between the groups. The median overall survival was 55.8 months for the nontransfused group, and 34.3 months for the transfused group (P=.06). Median disease-free survival was 16.1 months for the nontransfused group compared with 12.4 months for the transfused group (P=.25). Cox regression multivariate analysis showed that transfusion, cirrhosis, and venous invasion worsened overall survival. Venous invasion, cirrhosis, and tumor size adversely affected disease-free survival. Conclusions: The LTS group lost less blood and required less blood transfusions than the HBPS group. Blood transfusion worsened overall survival. The significantly lower blood transfusion requirement of the LTS group contributes to a potential advantage in their overall survival.
Persistent Identifierhttp://hdl.handle.net/10722/84442
ISSN
2014 Impact Factor: 4.926
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorChan, SCen_HK
dc.contributor.authorLiu, CLen_HK
dc.contributor.authorLo, CMen_HK
dc.contributor.authorLam, CMen_HK
dc.contributor.authorPoon, RTPen_HK
dc.contributor.authorYuen, WKen_HK
dc.contributor.authorFan, STen_HK
dc.contributor.authorWong, Jen_HK
dc.date.accessioned2010-09-06T08:53:00Z-
dc.date.available2010-09-06T08:53:00Z-
dc.date.issued2003en_HK
dc.identifier.citationArchives Of Surgery, 2003, v. 138 n. 3, p. 265-271en_HK
dc.identifier.issn0004-0010en_HK
dc.identifier.urihttp://hdl.handle.net/10722/84442-
dc.description.abstractBackground: Live donor liver transplantation (LDLT) mandates conversance in liver anatomy and major hepatectomy. Hepatocellular carcinoma is most reliably treated by hepatectomy. Hypothesis: The outcomes of major hepatectomy for hepatocellular carcinoma are influenced by the surgeon's LDLT experience. Design: We collected prospective cohort study data on patient and disease characteristics. Setting: Tertiary referral center. Patients: A retrospective study was performed on 250 patients who underwent major hepatectomy for hepatocellular carcinoma from January 16, 1996, through December 28, 2001. Main Outcome Measures: Overall and disease-free survival and outcomes including blood loss, blood transfusion, and complications. Results: The 3 liver transplantation surgeons (LTSs) performed 102 major hepatectomies; the 4 hepatobiliary and pancreatic surgeons (HBPSs), 148 major hepatectomics. Patients in both groups had similar baseline characteristics. The mean±SD blood loss in the LTS and HBPS groups was 1.36±1.37 and 2.21±2.40 L, respectively (P<.001). The mean±SD blood transfusion in the LTS and HBPS groups was 0.27±0.82 and 0.51±0.94 L, respectively (P=.001). Fewer patients in the LTS group required blood transfusion (17/102 [16.7%]; HBPS group, 57/148 [38:5%]; P<.001). We found no difference in overall and disease-free survival between the groups. The median overall survival was 55.8 months for the nontransfused group, and 34.3 months for the transfused group (P=.06). Median disease-free survival was 16.1 months for the nontransfused group compared with 12.4 months for the transfused group (P=.25). Cox regression multivariate analysis showed that transfusion, cirrhosis, and venous invasion worsened overall survival. Venous invasion, cirrhosis, and tumor size adversely affected disease-free survival. Conclusions: The LTS group lost less blood and required less blood transfusions than the HBPS group. Blood transfusion worsened overall survival. The significantly lower blood transfusion requirement of the LTS group contributes to a potential advantage in their overall survival.en_HK
dc.languageengen_HK
dc.publisherAmerican Medical Association. The Journal's web site is located at http://www.archsurg.comen_HK
dc.relation.ispartofArchives of Surgeryen_HK
dc.subject.meshCarcinoma, Hepatocellular - mortality - pathology - surgery-
dc.subject.meshClinical Competence-
dc.subject.meshHepatectomy-
dc.subject.meshLiver Neoplasms - mortality - pathology - surgery-
dc.subject.meshLiver Transplantation - methods-
dc.titleValue of live donor liver transplantation experience in major hepatectomy for hepatocellular carcinomaen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0004-0010&volume=138&issue=3&spage=265&epage=271&date=2003&atitle=Value+of+live+donor+liver+transplantation+experience+in+major+hepatectomy+for+hepatocellular+carcinomaen_HK
dc.identifier.emailChan, SC: chanlsc@hkucc.hku.hken_HK
dc.identifier.emailLo, CM: chungmlo@hkucc.hku.hken_HK
dc.identifier.emailPoon, RTP: poontp@hku.hken_HK
dc.identifier.emailFan, ST: stfan@hku.hken_HK
dc.identifier.emailWong, J: jwong@hkucc.hku.hken_HK
dc.identifier.authorityChan, SC=rp01568en_HK
dc.identifier.authorityLo, CM=rp00412en_HK
dc.identifier.authorityPoon, RTP=rp00446en_HK
dc.identifier.authorityFan, ST=rp00355en_HK
dc.identifier.authorityWong, J=rp00322en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1001/archsurg.138.3.265en_HK
dc.identifier.pmid12611572-
dc.identifier.scopuseid_2-s2.0-0037334691en_HK
dc.identifier.hkuros77127en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0037334691&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume138en_HK
dc.identifier.issue3en_HK
dc.identifier.spage265en_HK
dc.identifier.epage271en_HK
dc.identifier.isiWOS:000181435200008-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridChan, SC=7404255575en_HK
dc.identifier.scopusauthoridLiu, CL=7409789712en_HK
dc.identifier.scopusauthoridLo, CM=7401771672en_HK
dc.identifier.scopusauthoridLam, CM=36799183200en_HK
dc.identifier.scopusauthoridPoon, RTP=7103097223en_HK
dc.identifier.scopusauthoridYuen, WK=7102761292en_HK
dc.identifier.scopusauthoridFan, ST=7402678224en_HK
dc.identifier.scopusauthoridWong, J=8049324500en_HK

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