Wait and transplant for stage 2 hepatocellular carcinoma with deceased-donor liver grafts.

Abstract

BACKGROUND:

As a new scheme at our center, a Model for End-stage Liver Disease score of 18 points is assigned to candidates of deceased-donor liver transplantation (DDLT) who have hepatocellular carcinoma (HCC) remaining at stage 2 six months after their disease has been confirmed stage 2 HCC. Two points are added every 3 months if their disease remains at stage 2 or below. This study evaluated patient and tumor characteristics as well as surgical and short-term outcomes of DDLT in these patients.

METHODS:

Comparison of survival was made among three groups of patients who underwent liver transplantation (LT) in the same period. Group 1 consisted of 22 HCC patients who received DDLT under the new scheme. Group 2 consisted of 18 HCC patients who underwent living-donor LT. Group 3 consisted of 52 patients who underwent DDLT because of liver failure, among whom 6 had HCC but were not included in the new scheme.

RESULTS:

Group 1 had a median follow-up period of 17.9 months, and the 1-, 3-, and 5-year overall survival rates were 100%, 100%, and 80%, respectively. Group 2 had the corresponding rates at 100%, 100%, and 100% with a median follow-up of 19.6 months. Group 3 had the corresponding rates at 96.1%, 96.1%, and 96.1% with a median follow-up of 19.4 months.

CONCLUSIONS:

The policy of a 6-month wait has benefited the HCC patients who practically had no chance of undergoing living-donor LT. Their survival outcomes will be excellent as long as they can stand the test of time.

• Authors: See Ching Chan, William W Sharr, Kenneth S H Chok, Albert C Y Chan, Chung Mau Lo
• Journal: Transplantation (Transplantation) Vol. 96 Issue 11 Pg. 995-9 (Dec 15 2013) ISSN: 1534-6080 [Electronic] United States
• PMID: 23924774 (Publication Type: Comparative Study, Journal Article)

Topics

• Adolescent
• Adult
• Aged
• Carcinoma, Hepatocellular (mortality, pathology, surgery)
• Chi-Square Distribution
• Decision Support Techniques
• Female
• Humans
• Kaplan-Meier Estimate
• Liver Neoplasms (mortality, pathology, surgery)
• Liver Transplantation (adverse effects, mortality)
• Male
• Middle Aged
• Neoplasm Staging
• Patient Selection
• Risk Factors
• Survival Rate
• Time Factors
• Tissue and Organ Procurement
• Treatment Outcome
• Waiting Lists (mortality)
• Young Adult