Long-term outcomes of living donor liver transplantation after locoregional treatment for hepatocellular carcinoma: an experience from a single institute

Kenta Inomata, Hiroshi Yagi, Taizo Hibi, Masahiro Shinoda, Kentaro Matsubara, Yuta Abe, Minoru Kitago, Hideaki Obara, Osamu Itano, Shigeyuki Kawachi, Minoru Tanabe, Go Wakabayashi, Motohide Shimazu, Yuko Kitagawa

Research output: Contribution to journalArticle

Abstract

Purpose: The precise role of downstaging or bridge therapy for cirrhotic patients with hepatocellular carcinoma (HCC) beyond or within the Milan criteria (MC) before living donor liver transplantation (LDLT) remains undefined. Methods: We conducted a single-center, retrospective cohort study of 40 cirrhotic patients with HCC who underwent LDLT from 2000 to 2018. Dynamic computed tomography images at the initial presentation and immediately before LDLT as well as the final histopathological findings were reviewed to determine whether they met or exceeded MC. Results: Overall, 29 patients underwent various pre-transplant HCC treatments, including ablation and embolization (bridge therapy, n = 20; downstaging, n = 9). Of the 9 patients who were initially beyond the MC, 4 (44.4%) were successfully downstaged to within the MC. Five patients beyond the MC immediately before LDLT demonstrated a significantly worse 5-year overall survival rate than patients within the MC (16.7% vs. 82.2%, P = 0.004), regardless of the radiological HCC stage at presentation or the final pathological tumor status. All 3 recurrent patients had HCC beyond the MC immediately before transplant and died of their disease at 13, 24, and 50 months after transplantation. Conclusions: Successful downstaging for HCC cases beyond the MC provides similar outcomes to those within the MC at presentation, regardless of the histopathological findings.

Original languageEnglish
JournalSurgery today
DOIs
Publication statusAccepted/In press - 2020

Keywords

  • Downstage
  • Hepatocellular carcinoma
  • Liver transplantation
  • Locoregional therapy
  • Milan criteria

ASJC Scopus subject areas

  • Surgery

Fingerprint Dive into the research topics of 'Long-term outcomes of living donor liver transplantation after locoregional treatment for hepatocellular carcinoma: an experience from a single institute'. Together they form a unique fingerprint.

  • Cite this