1. Living donor liver transplantation for hepatocellular carcinoma beyond the Milan criteria: outcome of expanded criteria in tumor size
- Author
-
Chia-En Hsieh, Yao-Li Chen, Ya-Lan Hsu, Chih-Jan Ko, Yu-Ju Hung, Hsin-Rou Liang, and Kuo-Hua Lin
- Subjects
medicine.medical_specialty ,Carcinoma, Hepatocellular ,RD1-811 ,Hepatocellular carcinoma ,medicine.medical_treatment ,education ,Economic shortage ,Milan criteria ,Liver transplantation ,Living donor ,Living Donors ,Medicine ,Humans ,Survival rate ,Retrospective Studies ,Tumor size ,business.industry ,Research ,Living donor liver transplantation ,Liver Neoplasms ,General Medicine ,medicine.disease ,Beyond the Milan criteria ,Surgery ,Liver Transplantation ,Treatment Outcome ,Neoplasm Recurrence, Local ,business - Abstract
Background The Milan criteria are the universal standard of liver transplantation for hepatocellular carcinoma (HCC). Numerous expanded criteria have shown outcomes as good as the Milan criteria. In Taiwan, living donor liver transplant (LDLT) accounts for the majority of transplantations due to organ shortages. Methods We retrospectively enrolled 155 patients who underwent LDLT for HCC from July 2005 to June 2017 and were followed up for at least 2 years. Patients beyond the Milan criteria (n = 78) were grouped as recurrent or nonrecurrent, and we established new expanded criteria based on these data. Results Patients beyond the Milan criteria with recurrence (n = 31) had a significantly larger maximal tumor diameter (4.13 ± 1.96 cm versus 6.10 ± 3.41 cm, p = 0.006) and total tumor diameter (7.19 ± 4.13 cm versus 10.21 ± 5.01 cm, p = 0.005). Therefore, we established expanded criteria involving maximal tumor diameter ≤ 6 cm and total tumor diameter Conclusion Currently, patients with HCC who undergo LDLT can achieve good outcomes even when they are beyond the Milan criteria. Under the new expanded criteria, patients can achieve outcomes as good as those with the Milan criteria and more patients can benefit.
- Published
- 2021