Living donor liver transplantation for hepatocellular carcinoma: Milan criteria versus University of California San Francisco

2018 ◽  
Vol 37 (1) ◽  
pp. 116
Author(s):  
Ahmed Khalil ◽  
HaniSaid Abdelbaset ◽  
Ahmed Hilal
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
San Francisco ◽  
Living Donor ◽  
Living Donor Liver Transplantation ◽  
University Of California ◽  
Milan Criteria ◽  
Donor Liver ◽  
Donor Liver Transplantation

scholarly journals Clinical efficacy of locoregional therapy prior to living donor liver transplantation for hepatocellular carcinoma based on UCSF criteria

2019 ◽  
Author(s):  
Tsung-Han Wu ◽  
Chih-Hsien Cheng ◽  
Chen-Fang Lee ◽  
Ting-Jung Wu ◽  
Hong-Shiue Chou ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
San Francisco ◽  
Living Donor ◽  
Living Donor Liver Transplantation ◽  
Locoregional Therapy ◽  
Donor Liver ◽  
Donor Liver Transplantation ◽  
Regional Therapy ◽  
Ucsf Criteria

Abstract Background The study analyzed the loco-regional therapy outcomes prior to living donor liver transplantation (LDLT), to provide additional information for decision-making regarding therapeutic strategy for hepatocellular carcinoma (HCC) patients. Methods A total of 308 consecutive patients undergoing LDLTs for HCC between August 2004 and December 2018 were retrospectively analyzed. Patients subjected to loco-regional therapy prior to LT were grouped and the outcomes were compared. Results Overall, HCC recurrence after LDLT were detected in 38 patients (12.3%) during the follow-up period. By the end of the study, 205 patients, 6 of whom with recurrent HCC, were alive. Patients who had radiological imaging beyond the University of California at San Francisco (UCSF) criteria had significant inferior outcomes for both recurrence-free survival (RFS, p = 0.0005) and overall survival (OS, p = 0.0462) despite receiving loco-regional therapy as down-staging intention. Moreover, patients with profound tumor necrosis (TN) had a superior RFS at 3 and 5 years (97.4% and 93.8%, respectively), compared with others. Conclusion LDLT gains a satisfactory result based on the expanded UCSF criteria for HCC. However, the loco-regional therapy prior to LDLT does not seem to provide benefit unless a profound TN is noted.

Living donor liver transplantation in hepatocellular carcinoma beyond the Milan criteria

2008 ◽  
Vol 28 (8) ◽  
pp. 1120-1128 ◽  
Author(s):  
Hyun Young Woo ◽  
Jeong Won Jang ◽  
Jong Young Choi ◽  
Chan Ran You ◽  
Soung Won Jeong ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Living Donor ◽  
Living Donor Liver Transplantation ◽  
Milan Criteria ◽  
Donor Liver ◽  
Donor Liver Transplantation

Pharyngeal metastasis following living-donor liver transplantation for hepatocellular carcinoma: case report and review of literature

2020 ◽  
Author(s):  
Taiji Tohyama ◽  
Katsunori Sakamoto ◽  
Kei Tamura ◽  
Taro Nakamura ◽  
Jota Watanabe ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Lymph Node ◽  
Lymph Node Dissection ◽  
Living Donor ◽  
Living Donor Liver Transplantation ◽  
Milan Criteria ◽  
Node Dissection ◽  
Donor Liver ◽  
Donor Liver Transplantation

Abstract Background: The most common sites of recurrence after liver transplantation for hepatocellular carcinoma (HCC) have been reported to be the liver, lung, bone, and adrenal glands, but there have also been many reports of cases of multiple recurrence. The prognosis after recurrence is poor, with reported median survival after recurrence of HCC ranging from 9 to 19 months. Here, we report a case of long-term survival after recurrence of pharyngeal metastasis following living-donor liver transplantation (LDLT) for HCC within the Milan criteria, by resection of the metastatic region and cervical lymph node dissection. Case presentation: A 47-year-old man with a Model End-stage Liver Disease (MELD) score of 11 underwent LDLT for HCC within the Milan criteria for liver cirrhosis associated with hepatitis B virus infection, with his 48-year-old elder brother as the living donor. One year and 10 months after liver transplantation, he visited a nearby hospital with a chief complaint of discomfort on swallowing. A pedunculated polyp was found in the hypopharynx, and biopsy revealed HCC metastasis. We performed pharyngeal polypectomy. Two years later, cervical lymph nodes metastasis appeared, and neck lymph node dissection was performed. Although recurrence subsequently occurred three times in the grafted liver, the patient is still alive 12 years and 10 months after recurrence of pharyngeal metastasis. He is now a tumor-free outpatient taking sorafenib. Conclusion: It is necessary to recognize that the nasopharyngeal region is a potential site of HCC metastasis. Prognostic improvement can be expected with close follow-up, early detection, and multidisciplinary treatment, including radical resection.

scholarly journals Living Donor Liver Transplantation: The Optimal Curative Treatment for Hepatocellular Carcinoma Even Beyond Milan Criteria

2021 ◽  
Vol 28 ◽  
pp. 107327482110119
Author(s):  
Altan Alim ◽  
Yalcin Erdogan ◽  
Murat Dayangac ◽  
Yildiray Yuzer ◽  
Yaman Tokat ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Prognostic Factors ◽  
Vascular Invasion ◽  
Living Donor ◽  
Living Donor Liver Transplantation ◽  
Alpha Fetoprotein ◽  
Milan Criteria ◽  
Donor Liver ◽  
Donor Liver Transplantation

Introduction: Liver transplantation offers the most reasonable expectation for curative treatment for hepatocellular carcinoma. Living-donor liver transplantation represents a treatment option, even in patients with extended Milan criteria. This study aimed to evaluate the outcomes of hepatocellular carcinoma patients, particularly those extended Milan criteria. Materials and Patients: All HCC patients who received liver transplant for HCC were included in this retrospective study. Clinical characteristics including perioperative data and survival data (graft and patient) were extracted from records. Univariate and multivariate analyses was performed to identify significant prognostic factors for survival, postoperative complications and recurrence. Results: Two-hundred and two patients were included. The median age was 54.8 years (IQR 53-61). Fifty-one patients (25.3%) underwent deceased donors liver transplantation and 151 patients (74.7%) underwent living donor liver transplantation. Perioperative mortality rate was 5.9% (12 patients). Recurrent disease occurred in 43 patients (21.2%). The overall 1-year and 5-year survival rates were 90.7% and 75.6%, respectively. Significant differences between patients beyond Milan criteria compared to those within Milan criteria were not found. Alpha-fetoprotein level >300 ng/mL, vascular invasion, and bilobar tumor lesions were independent negative prognostic factors for survival. Conclusion: Liver transplantation is the preferred treatment for hepatocellular carcinoma and it has demonstrated an excellent potential to cure even in patients with beyond Milan criteria. This study shows that the Milan criteria alone are not sufficient to predict survival after transplantation. The independent parameters for survival prediction are Alpha-Fetoprotein-value and status of vascular invasion.

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