Wednesday, February 23, 2011 (Last Updated: 02/24/2011)
WEDNESDAY, Feb. 23 (HealthDay News) -- Recurrence and survival outcomes are similar for patients with hepatocellular carcinoma (HCC) following living donor liver transplant (LDLT) and deceased donor liver transplant (DDLT), according to a study published online Feb. 11 in Hepatology.
Prashant Bhangui, of the Hôpital Paul Brousse in Villejuif, France, and colleagues performed an intention-to-treat analysis comparing recurrence rates and survival outcome in cirrhotic HCC patients after LDLT and DDLT. Of the 183 study participants, 36 were listed to receive LDLT and 147 DDLT. Twenty-seven patients dropped out from the DDLT list, most of them because of progression. The primary study end point was tumor recurrence.
The investigators found that there was a significantly shorter waiting time in the LDLT group. Rates of tumor recurrence and overall survival were similar, with an insignificant association toward longer time to recurrence seen after LDLT. For tumors that exceeded the University of California, San Francisco (UCSF) criteria, the tumor grade and presence of microvascular invasion were identified as predictive factors for recurrence. For patients beyond the UCSF and Milan criteria, there was a nonsignificant association with worse outcome with LDLT compared to DDLT.
"LDLT does as well as DDLT in terms of recurrence and survival outcomes. In addition, the significantly shorter waiting time (aiding to avoid drop-outs from the waiting list), is a major advantage of using LDLT. However, one has to be cautious while expanding the criteria for LDLT in HCC patients as this may lead to worse long-term outcomes," the authors write.
Hematology & Oncology
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