Details

Autor(en) / Beteiligte

• Park, H.-W
• Hwang, S
• Ahn, C.-S
• Kim, K.-H
• Moon, D.-B
• Ha, T.-Y
• Song, G.-W
• Jung, D.-H
• Park, G.-C
• Namgoong, J.-M
• Park, C.-S
• Park, Y.-H
• Kang, S.-H
• Jung, B.-H
• Lee, S.-G

Titel

Long-term Survival Outcomes for Living Donor Liver Transplant Recipients With Pathologically Nonviable Hepatocellular Carcinoma

Ist Teil von

• Transplantation proceedings, 2013-10, Vol.45 (8), p.3032-3034

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2013

Quelle

MEDLINE

Beschreibungen/Notizen

• Abstract Purpose Complete necrosis of hepatocellular carcinoma (HCC) lesions has occasionally been found by explant pathology after pretransplant neoadjuvant treatment. This study sought to investigate the long-term prognostic effect of loss of tumor viability after HCC treatment in living donor liver transplant (LDLT) recipients. Methods We reviewed retrospectively the 5-year records of 37 patients who demonstrated nonviable HCC on explant pathology. Results The most common primary disease was hepatitis-B-virus-associated liver cirrhosis ( n  = 34). Single explant tumors were found in 29 patients; the mean maximal tumor size was 2.1 ± 0.9 cm (range: 0.8–4.0). No patients showed microvascular invasion. The median level of alpha-fetoprotein was 12 ng/mL (range: 1–1160). The 1 patient who showed a recurrence at 20 months remains alive more than 6 years after adrenalectomy and repeated pulmonary metastasectomy. The 5-year HCC recurrence rate was thus 2.1%. There were 2 late mortalities, each due to graft failure and recurrent gastric cancer. The overall patient survival rate was 97.3% at 5 and 92.7% at 10 years. Conclusions The results of this study revealed that the loss of tumor viability induced by pretransplant neoadjuvant treatment definitely decreased the risk of post-transplant HCC recurrence. Therefore, patients with nonviable HCC can be regarded as members of a superselect group with minimal risk for HCC recurrence, and may be exempted from routine HCC screening.