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Transplant Proc. 2009 May;41(4):1283-5. doi: 10.1016/j.transproceed.2009.03.022.

Living donor liver transplantation for hepatocellular carcinoma: long-term results compared with deceased donor liver transplantation.

Author information

  • 1Department of Surgery and Abdominal Transplantation, Niguarda Ca' Granda Hospital, Milan, Italy. stefano.disandro@ospedaleniguarda.it

Abstract

OBJECTIVE:

Living donor liver transplantation (LDLT) may represent a valid therapeutic option allowing several advantages for patients affected by hepatocellular carcinoma (HCC) awaiting orthotopic liver transplantation (OLT). However, some reports in the literature have demonstrated worse long-term and disease-free survivals among patients treated by LDLT than deceased donor liver transplantation (DDLT) for HCC. Herein we have reported our long-term results comparing LDLT with DDLT for HCC.

PATIENTS AND METHODS:

Among 179 patients who underwent OLT from January 2000 to December 2007, 25 (13.9%) received LDLT with HCC 154 (86.1%) received DDLT. Patients were selected based on the Milan criteria. Transarterial chemoembolization, radiofrequency ablation, percutaneous alcoholization, or liver resection was applied as a downstaging procedure while on the waiting list. Patients with stage II HCC were proposed for LDLT.

RESULTS:

The overall 3- and 5-year survival rates were 77.3% and 68.7% versus 82.8% and 76.7% for LDLT and DDLT recipients, respectively, with no significant difference by the log-rank test. Moreover, the 3- and 5-year recurrence-free survival rates were 95.5% and 95.5% (LDLT) versus 90.5% and 89.4% (DDLT; P = NS).

CONCLUSIONS:

LDLT guarantees the same long-term results as DDLT where there are analogous selection criteria for candidates. The Milan criteria remain a valid tool to select candidates for LDLT to achieve optimal long-term results.

PMID:
19460539
[PubMed - indexed for MEDLINE]
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