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Liver transplant results for hepatocellular carcinoma applying strict preoperative selection criteria.

Abstract：

INTRODUCTION:Liver transplantation is currently the best therapeutic option for small hepatocellular carcinoma (HC) in selected cirrhotic patients. The main aim of this study was to analyze the results of a recent series of liver transplant cirrhotic patients with small HC applying strict preoperative selection criteria. PATIENTS AND METHODS:During a period of 6 years we performed 53 liver transplants with a final diagnosis of HC on cirrhosis. The selection criteria for liver transplantation (LT) by modern imaging techniques were the Milan criteria (TNM I and II of the modified classification). RESULTS:Of the 53 patients, 44 (83%) were transplanted with preoperatively known HC, and 9 (17%) with incidental HC. The mean time on the waiting list was 74 +/- 62 days. Despite using strict selection criteria, 23 patients (43%) exceeded the Milan criteria in the specimen and 17 (32%) even exceeded the extended criteria of the UCSF. With a mean follow-up of 2 years, only two patients have developed recurrences. The overall survival at 1, 3, and 5 years was 80%, 70%, and 70%, respectively. The survival of patients that exceeded the Milan or USF criteria at 1, 3, and 5 years was 72% and 76%; 67% and 69%; 67% and 69%, respectively. CONCLUSIONS:The results of liver transplantation for HC are excellent when applying strict preoperative selection criteria. The current imaging methods lead to a considerable infrastaging percentage (30% to 40%), extending the indications for liver transplant due to HC beyond the scope that clinical reports would justify.

journal_name

Transplant Proc

journal_title

Transplantation proceedings

authors

Santoyo J,Suarez MA,Fernández-Aguilar JL,Jiménez M,Perez Daga JA,Sánchez-Perez B,Gonzalez Poveda I,Gonzalez-Sanchez A,Ramírez C,de la Fuente A

doi

10.1016/j.transproceed.2005.02.059

subject

Has Abstract

pub_date

2005-04-01 00:00:00

pages

1488-90

issue

3

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(05)00175-2

journal_volume

37

pub_type

杂志文章

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