Objective: To determine outcome in patients undergoing LT for NETs, and compared them with outcomes in patients with primary liver malignancies such as Hepatocellular Carcinoma (HCC), Cholangiocarcinoma (CC) and Mixed Hepatocellular Carcinoma/Cholangiocarcinoma (HCC-CC). Methods: A retrospective analysis of patients undergoing LT for NETs was performed using the United Network for Organ Sharing (UNOS) database from 1994-2013. Overall and disease-free survival (OS, DFS) in patients with NETs, HCC, CC and HCC-CC were compared. Results: Of the 123,167 patients who underwent LT, 177 patients had diagnosis of metastases from NET compared to 4,049 patients with a primary malignancy (94 HCC-CC; 3,515 HCC; 440 CC). MELD at the time of listing did not significantly differ among the four groups. Sixty-five percent of the patients with NETs recurred in a median of 39 months. Overall Survival at 5 and 10 year survival for NETs was 49% and 34%, for CC 47% and 39%, for mixed HCC-CC 40% and 40% and for HCC 62% and 44%, respectively. DFS at 10 years, for NET was 29%, for mixed HCC-CC was 38% and for CC was 36% and for HCC 41%. Conclusions: Overall 5 year survival rates of patients transplanted for HCC are better than those transplanted for CC, mixed HCC-CC and metastatic NETs. However, long-term survival (OS and DFS) in these patients after 10 years is not significantly different.

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