Hepatocellular carcinoma recurrence and death following living and deceased donor liver transplantation.

Published

Journal Article

We examined mortality and recurrence of hepatocellular carcinoma (HCC) among 106 transplant candidates with cirrhosis and HCC who had a potential living donor evaluated between January 1998 and February 2003 at the nine centers participating in the Adult-to-Adult Living Donor Liver Transplantation Cohort Study (A2ALL). Cox regression models were fitted to compare time from donor evaluation and time from transplant to death or HCC recurrence between 58 living donor liver transplant (LDLT) and 34 deceased donor liver transplant (DDLT) recipients. Mean age and calculated Model for End-Stage Liver Disease (MELD) scores at transplant were similar between LDLT and DDLT recipients (age: 55 vs. 52 years, p = 0.21; MELD: 13 vs. 15, p = 0.08). Relative to DDLT recipients, LDLT recipients had a shorter time from listing to transplant (mean 160 vs. 469 days, p < 0.0001) and a higher rate of HCC recurrence within 3 years than DDLT recipients (29% vs. 0%, p = 0.002), but there was no difference in mortality or the combined outcome of mortality or recurrence. LDLT recipients had lower relative mortality risk than patients who did not undergo LDLT after the center had more experience (p = 0.03). Enthusiasm for LDLT as HCC treatment is dampened by higher HCC recurrence compared to DDLT.

Full Text

Duke Authors

Cited Authors

  • Fisher, RA; Kulik, LM; Freise, CE; Lok, ASF; Shearon, TH; Brown, RS; Ghobrial, RM; Fair, JH; Olthoff, KM; Kam, I; Berg, CL; A2ALL Study Group,

Published Date

  • June 2007

Published In

Volume / Issue

  • 7 / 6

Start / End Page

  • 1601 - 1608

PubMed ID

  • 17511683

Pubmed Central ID

  • 17511683

International Standard Serial Number (ISSN)

  • 1600-6135

Digital Object Identifier (DOI)

  • 10.1111/j.1600-6143.2007.01802.x

Language

  • eng

Conference Location

  • United States