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Article: Living donor versus deceased donor liver transplantation for early irresectable hepatocellular carcinoma

TitleLiving donor versus deceased donor liver transplantation for early irresectable hepatocellular carcinoma
Authors
Issue Date2007
PublisherJohn Wiley & Sons Ltd. The Journal's web site is located at http://www.bjs.co.uk
Citation
British Journal Of Surgery, 2007, v. 94 n. 1, p. 78-86 How to Cite?
AbstractBackground: Hypothetical studies that favour living donor liver transplantation (LDLT) for early hepatocellular carcinoma (HCC) assumed a comparable outcome after LDLT and deceased donor liver transplantation (DDLT). The aim of this study was to compare the outcome after LDLT with that after DDLT, and to identify factors that might account for any differences. Methods: The study included 60 patients who met the radiological Milan or University of California at San Francisco (UCSF) criteria and underwent LDLT (43 patients) or DDLT (17). Results: The LDLT group had fewer incidental tumours and a lower rate of pretransplant transarterial chemoembolization but a higher rate of salvage transplantation. Waiting time was shorter and graft weight to standard liver weight (GW:SLW) ratio was lower in this group. The perioperative course, and histopathological tumour size, number, grade and stage were comparable. Median follow-up was 33 (range 4-120) months. The cumulative 5-year recurrence rate was 29 per cent in the LDLT group and 0 per cent in the DDLT group (P = 0.029). A GW:SLW ratio of 0.6 or less, salvage transplantation, three or more tumour nodules, microscopic vascular invasion, and pathological stage beyond the Milan or UCSF criteria were significant confounding risk factors. Multivariable analysis identified salvage transplantation (relative risk 5.16 (95 percent confidence interval (c.i.) 1.48 to 18.02); P = 0.010) and pathological stage beyond the UCSF criteria (relative risk 4.10 (95 per cent c.i. 1.02 to 16.48); P = 0.047) as independent predictors of recurrence. Conclusion: Despite standard radiological selection criteria based on number and size, patients who underwent LDLT for HCC had more recurrence because of selection bias for other clinical characteristics. Copyright © 2006 British Journal of Surgery Society Ltd.
Persistent Identifierhttp://hdl.handle.net/10722/88388
ISSN
2015 Impact Factor: 5.596
2015 SCImago Journal Rankings: 2.966
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLo, CMen_HK
dc.contributor.authorFan, STen_HK
dc.contributor.authorLiu, CLen_HK
dc.contributor.authorChan, SCen_HK
dc.contributor.authorNg, IOLen_HK
dc.contributor.authorWong, Jen_HK
dc.date.accessioned2010-09-06T09:42:43Z-
dc.date.available2010-09-06T09:42:43Z-
dc.date.issued2007en_HK
dc.identifier.citationBritish Journal Of Surgery, 2007, v. 94 n. 1, p. 78-86en_HK
dc.identifier.issn0007-1323en_HK
dc.identifier.urihttp://hdl.handle.net/10722/88388-
dc.description.abstractBackground: Hypothetical studies that favour living donor liver transplantation (LDLT) for early hepatocellular carcinoma (HCC) assumed a comparable outcome after LDLT and deceased donor liver transplantation (DDLT). The aim of this study was to compare the outcome after LDLT with that after DDLT, and to identify factors that might account for any differences. Methods: The study included 60 patients who met the radiological Milan or University of California at San Francisco (UCSF) criteria and underwent LDLT (43 patients) or DDLT (17). Results: The LDLT group had fewer incidental tumours and a lower rate of pretransplant transarterial chemoembolization but a higher rate of salvage transplantation. Waiting time was shorter and graft weight to standard liver weight (GW:SLW) ratio was lower in this group. The perioperative course, and histopathological tumour size, number, grade and stage were comparable. Median follow-up was 33 (range 4-120) months. The cumulative 5-year recurrence rate was 29 per cent in the LDLT group and 0 per cent in the DDLT group (P = 0.029). A GW:SLW ratio of 0.6 or less, salvage transplantation, three or more tumour nodules, microscopic vascular invasion, and pathological stage beyond the Milan or UCSF criteria were significant confounding risk factors. Multivariable analysis identified salvage transplantation (relative risk 5.16 (95 percent confidence interval (c.i.) 1.48 to 18.02); P = 0.010) and pathological stage beyond the UCSF criteria (relative risk 4.10 (95 per cent c.i. 1.02 to 16.48); P = 0.047) as independent predictors of recurrence. Conclusion: Despite standard radiological selection criteria based on number and size, patients who underwent LDLT for HCC had more recurrence because of selection bias for other clinical characteristics. Copyright © 2006 British Journal of Surgery Society Ltd.en_HK
dc.languageengen_HK
dc.publisherJohn Wiley & Sons Ltd. The Journal's web site is located at http://www.bjs.co.uken_HK
dc.relation.ispartofBritish Journal of Surgeryen_HK
dc.rightsBritish Journal of Surgery. Copyright © John Wiley & Sons Ltd.en_HK
dc.rightsSpecial Statement for Preprint only Before publication: 'This is a preprint of an article accepted for publication in [The Journal of Pathology] Copyright © ([year]) ([Pathological Society of Great Britain and Ireland])'. After publication: the preprint notice should be amended to follows: 'This is a preprint of an article published in [include the complete citation information for the final version of the Contribution as published in the print edition of the Journal]' For Cochrane Library/ Cochrane Database of Systematic Reviews, add statement & acknowledgement : ‘This review is published as a Cochrane Review in the Cochrane Database of Systematic Reviews 20XX, Issue X. Cochrane Reviews are regularly updated as new evidence emerges and in response to comments and criticisms, and the Cochrane Database of Systematic Reviews should be consulted for the most recent version of the Review.’ Please include reference to the Review and hyperlink to the original version using the following format e.g. Authors. Title of Review. Cochrane Database of Systematic Reviews 20XX, Issue #. Art. No.: CD00XXXX. DOI: 10.1002/14651858.CD00XXXX (insert persistent link to the article by using the URL: http://dx.doi.org/10.1002/14651858.CD00XXXX) (This statement should refer to the most recent issue of the Cochrane Database of Systematic Reviews in which the Review published.)-
dc.subject.meshCarcinoma, Hepatocellular - pathology - surgery-
dc.subject.meshLiver Neoplasms - pathology - surgery-
dc.subject.meshLiver Transplantation - methods - pathology-
dc.subject.meshLiving Donors-
dc.subject.meshPostoperative Complications - etiology-
dc.titleLiving donor versus deceased donor liver transplantation for early irresectable hepatocellular carcinomaen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0007-1323&volume=94&issue=1&spage=78&epage=86&date=2007&atitle=Living+donor+versus+deceased+donor+liver+transplantation+for+early+irresectable+hepatocellular+carcinomaen_HK
dc.identifier.emailLo, CM: chungmlo@hkucc.hku.hken_HK
dc.identifier.emailFan, ST: stfan@hku.hken_HK
dc.identifier.emailChan, SC: chanlsc@hkucc.hku.hken_HK
dc.identifier.emailNg, IOL: iolng@hku.hken_HK
dc.identifier.emailWong, J: jwong@hkucc.hku.hken_HK
dc.identifier.authorityLo, CM=rp00412en_HK
dc.identifier.authorityFan, ST=rp00355en_HK
dc.identifier.authorityChan, SC=rp01568en_HK
dc.identifier.authorityNg, IOL=rp00335en_HK
dc.identifier.authorityWong, J=rp00322en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1002/bjs.5528en_HK
dc.identifier.pmid17016793-
dc.identifier.scopuseid_2-s2.0-33846455773en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-33846455773&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume94en_HK
dc.identifier.issue1en_HK
dc.identifier.spage78en_HK
dc.identifier.epage86en_HK
dc.identifier.isiWOS:000243741300014-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridLo, CM=7401771672en_HK
dc.identifier.scopusauthoridFan, ST=7402678224en_HK
dc.identifier.scopusauthoridLiu, CL=7409789712en_HK
dc.identifier.scopusauthoridChan, SC=7404255575en_HK
dc.identifier.scopusauthoridNg, IOL=7102753722en_HK
dc.identifier.scopusauthoridWong, J=8049324500en_HK
dc.identifier.citeulike1039108-

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