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J Surg Oncol. 2017 Mar;115(3):319-323. doi: 10.1002/jso.24515. Epub 2016 Nov 23.

Liver transplantation for fibrolamellar hepatocellular carcinoma: A national perspective.

Author information

1
Division of Transplant, Department of Surgery, University of Kentucky, College of Medicine, Lexington, Kentucky.
2
Division of Hepatology, Department of Internal Medicine, University of Kentucky, College of Medicine, Lexington, Kentucky.

Abstract

BACKGROUND:

Fibrolamellar Hepatocellular Carcinoma (FL-HCC) is a rare primary liver tumor that usually presents in younger patients without underlying liver disease.

METHODS:

We queried the United Network of Organ Sharing (UNOS) database between October 1988 and January 2013 to evaluate outcomes in patients with FL-HCC undergoing liver transplantation in the United States compared to patients with conventional Hepatocellular Carcinoma (HCC).

RESULTS:

Sixty-three patients were identified (57% female, mean age 30 years). Only one patient (2%) had an associated Hepatitis C Virus. Mean Model for End-Stage Liver Disease (MELD) score at the time of transplantation was 11.3. Mean waiting time was 325 days and mean cold ischemic time was 6 hr. Overall survival of FL-HCC patients at 1, 3, and 5 years was 96%, 80%, and 48% as compared to HCC patients whose rates were 89%, 77%, and 68%. Six patients had tumor recurrence (10%). The Cox Model demonstrated that MELD and cold ischemic time are the strongest predictors of overall survival in FL-HCC patients. Age and wait time were not associated with poor patient survival in this series.

CONCLUSIONS:

Good results can be obtained in selected patients transplanted for FL-HCC. FL-HCC patients had similar survival compared to those transplanted for HCC. J. Surg. Oncol. 2017;115:319-323. © 2016 Wiley Periodicals, Inc.

KEYWORDS:

fibrolamellar; fibrolamellar hepatocellular carcinoma; liver transplantation

PMID:
27878821
DOI:
10.1002/jso.24515
[Indexed for MEDLINE]

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