Liver Transplantation in Hepatocellular Carcinoma: Experiences from the Shiraz Transplant Center.

IF 0.3 Q4 TRANSPLANTATION International Journal of Organ Transplantation Medicine Pub Date : 2021-01-01

A Dastyar, H Nikoupour, A Shamsaeefar, P Arasteh, A BurBur, K Kazemi, M Dehghani, S Ghazimoghaddam, A K Sanaei, H Eghlimi, S A Malekhosseini, S Nikeghbalian

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引用次数: 0

Abstract

Background: Studies evaluating liver transplantation (LT) in hepatocellular carcinoma (HCC) in the Middle East have been scarce, mainly due to intricacy of this type of surgery.

Objective: In here we report our experiences with LT among patients with HCC cirrhosis.Methods: All patients who underwent LT with primary diagnosis of HCC older than 18 years old, during 2004 to 2019, were initially included in our study.

Results: Overall, 124 patients entered our study, among which majority were males (86.3%). Mean (SD) age of patients was 53.1±10.6 years old. Most common underlying liver diseases were HBV (55.6%) and HCV infections (12.1%). Mean MELD score of patients was 18±5.5. Child-Pugh score of most patients was class B (50%). Mean (SD) duration of hospitalization was 12.1±3.5 days. Patients were followed for a median of 32 (9, 62) months. The most common causes of death were recurrence of HCC (47.7%) and sepsis (34.1%). Median (IQR) duration to recurrence and death were 18 (4, 34) months and 17.5 (5.7, 44.5) months, respectively. One-year survival (89%, 86.4%, and 63.2%, respectively) (p=0.011) and one-year DFS (89%, 86.4%, and 57.9%, respectively) (p=0.001) was significant different between those who were selected based on the Milan, UCSF and extended criteria.

Conclusion: Our study provides valuable experiences on LT and HCC from one of the largest LT centers in the world. Accordingly, we found that the Milan criterion provides the best survival compared to the UCSF and our extended criteria for patient selection.

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肝细胞癌肝移植：设拉子移植中心的经验。

背景：中东地区对肝细胞癌（HCC）肝移植（LT）进行评估的研究很少，这主要是由于此类手术的复杂性：本文报告了我们在肝细胞癌肝硬化患者中开展肝移植手术的经验：2004年至2019年期间，所有接受过LT手术且初诊为HCC的18岁以上患者均被纳入我们的研究：共有124名患者参与研究，其中男性占多数（86.3%）。平均（标清）年龄为 53.1±10.6 岁。最常见的肝脏疾病是 HBV（55.6%）和 HCV 感染（12.1%）。患者的平均 MELD 评分为（18±5.5）分。大多数患者的 Child-Pugh 评分为 B 级（50%）。平均（标清）住院时间为 12.1±3.5 天。患者的随访时间中位数为 32（9，62）个月。最常见的死亡原因是HCC复发（47.7%）和败血症（34.1%）。复发和死亡的中位（IQR）持续时间分别为18（4，34）个月和17.5（5.7，44.5）个月。一年生存率（分别为89%、86.4%和63.2%）（P=0.011）和一年DFS（分别为89%、86.4%和57.9%）（P=0.001）在根据米兰标准、UCSF标准和扩展标准选择的患者之间存在显著差异：我们的研究为世界上最大的LT中心之一提供了有关LT和HCC的宝贵经验。结论：我们的研究提供了世界上最大的LT中心之一在LT和HCC方面的宝贵经验，因此我们发现，与UCSF和我们的扩展标准相比，米兰标准为患者提供了最佳的生存率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Organ Transplantation Medicine TRANSPLANTATION-

CiteScore

1.60

自引率

0.00%

发文量

审稿时长

12 weeks

期刊介绍： The International Journal of Organ Transplantation Medicine (IJOTM) is a quarterly peer-reviewed English-language journal that publishes high-quality basic sciences and clinical research on transplantation. The scope of the journal includes organ and tissue donation, procurement and preservation; surgical techniques, innovations, and novelties in all aspects of transplantation; genomics and immunobiology; immunosuppressive drugs and pharmacology relevant to transplantation; graft survival and prevention of graft dysfunction and failure; clinical trials and population analyses in the field of transplantation; transplant complications; cell and tissue transplantation; infection; post-transplant malignancies; sociological and ethical issues and xenotransplantation.