The role of living donor liver transplantation in colorectal cancer liver metastases.

IF 1.8 4区 医学 Q3 TRANSPLANTATION Current Opinion in Organ Transplantation Pub Date : 2025-02-01 Epub Date: 2024-11-28 DOI:10.1097/MOT.0000000000001188
Luckshi Rajendran, Gonzalo Sapisochin, Mark Cattral
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Abstract

Purpose of review: Despite technical and therapeutic advances, only 20-40% of patients with colorectal liver metastases (CRLM) have resectable disease. Historically, the remaining patients with unresectable, liver-only CRLM would receive palliative chemotherapy, with a median survival of 8 months.

Recent findings: Liver transplantation has emerged as a viable option for selected patients with CRLM. This advancement stems from improved understanding of tumour genomics and biology and better patient selection criteria. The results of recent prospective clinical trials have further ignited enthusiasm for liver transplantation as a viable therapeutic option. Living donor liver transplantation (LDLT) offers several advantages over deceased donor liver transplantation (DDLT) for this disease, including reduced wait-time and optimized timing and coordination of oncologic therapy. On-going LDLT clinical trials have demonstrated favourable outcomes as compared with other liver transplantation indications. However, there is no established consensus or standardization in the implementation of LDLT for CRLM, beyond trials and centre-specific protocols.

Summary: LDLT is an excellent therapeutic option in highly selected patients with CRLM. Refining prognostic factors and selection criteria will help to further optimize the utility and broaden the acceptance and implementation of LDLT for patients with CRLM.

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活体肝移植在结直肠癌肝转移中的作用。
综述目的:尽管技术和治疗方法不断进步,但只有20%-40%的结直肠肝转移瘤(CRLM)患者的疾病可以切除。历史上,其余无法切除、仅肝脏转移的 CRLM 患者将接受姑息化疗,中位生存期为 8 个月:最近的研究结果:肝移植已成为部分 CRLM 患者的可行选择。这一进步源于对肿瘤基因组学和生物学的进一步了解以及更好的患者选择标准。最近的前瞻性临床试验结果进一步点燃了人们对肝移植这一可行治疗方案的热情。活体肝移植(LDLT)与死者肝移植(DDLT)相比,在治疗这种疾病方面具有多项优势,包括缩短等待时间、优化肿瘤治疗的时机和协调。正在进行的LDLT临床试验显示,与其他肝移植适应症相比,LDLT的疗效更佳。总结:对于经过严格筛选的 CRLM 患者,LDLT 是一种极佳的治疗选择。完善预后因素和选择标准将有助于进一步优化LDLT的效用,扩大CRLM患者对LDLT的接受度和实施范围。
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来源期刊
CiteScore
4.10
自引率
4.50%
发文量
124
审稿时长
6-12 weeks
期刊介绍: ​​​​​​Current Opinion in Organ Transplantation is an indispensable resource featuring key, up-to-date and important advances in the field from around the world. Led by renowned guest editors for each section, every bimonthly issue of Current Opinion in Organ Transplantation delivers a fresh insight into topics such as stem cell transplantation, immunosuppression, tolerance induction and organ preservation and procurement. With 18 sections in total, the journal provides a convenient and thorough review of the field and will be of interest to researchers, surgeons and other healthcare professionals alike.
期刊最新文献
Transplant oncology: keeping the patient's perspective in mind. Editorial introductions. The importance of equity in transplant oncology. Giving a voice to patient and caregiver perspectives on equity in transplantation. The role of living donor liver transplantation in colorectal cancer liver metastases.
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