Rare Recurrence of Hepatocellular Carcinoma Greater than 6 Years after Living Donor Liver Transplant

N. Duong
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Abstract

Living donor liver transplant (LDLT) for patients within Milan criteria (one lesion smaller than 5 cm; up to 3 lesions smaller than 3 cm, no extrahepatic manifestations, no evidence of gross vascular invasion) has been an evolving modality for the treatment of hepatocellular carcinoma (HCC) in the last decade [1,2,3]. Orthotopic liver transplant (OLT) was once considered an experimental approach in the pediatric population has now gained its popularity in the management of liver cancer in adults and has led to shortening of time on the liver transplant (LT) waitlist. Observational studies have shown comparable outcomes between LDLT and deceased donor liver transplant (DDLT) with regards to overall survival and disease-free survival rates. Unfortunately, recurrence post LDLT as with DDLT remains an ongoing issue and rates up to 10% have been reported at 4 years post-transplant [4].
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活体肝移植术后6年以上肝癌罕见复发
活体供肝移植(LDLT)适用于符合米兰标准的患者(一个病变小于5厘米;在过去的十年中,肝细胞癌(HCC)的治疗方式不断发展,包括3个小于3cm的病变,无肝外表现,无明显血管侵犯的证据[1,2,3]。原位肝移植(OLT)曾经被认为是儿科人群的一种实验性方法,现在在成人肝癌的治疗中得到了普及,并缩短了肝移植(LT)等待名单上的时间。观察性研究表明,LDLT和死亡供体肝移植(DDLT)在总生存率和无病生存率方面具有可比性。不幸的是,与DDLT一样,LDLT术后的复发仍然是一个持续存在的问题,据报道,移植后4年的复发率高达10%。
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