Living Donor Liver Transplantation for Hepatocellular Carcinoma beyond UCSF Criteria: Can We Achieve a Modest Long-Term Survival? A Single Center Retrospective Analysis of Using Extended Criteria
Organ Transplantation Center, China Medical University Hospital, Taichung, Taiwan.
Meeting: 2018 American Transplant Congress
Abstract number: D271
Keywords: Hepatocellular carcinoma, Living-related liver donors
Session Information
Session Name: Poster Session D: Late Breaking
Session Type: Poster Session
Date: Tuesday, June 5, 2018
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall 4EF
Milan's criteria were universally validated for LT in HCC patients and, were accepted as allocation criteria of UNOS in 2001 & Eurotransplantation in 2006. However, due to restrictive nature of the Milan's criteria and ever-increasing HCC patient cohort, UCSF criteria was introduced which was first modest attempt to expand the criteria. In this study, we present our experience of LDLT for HCC patients beyond the UCSF criteria.
Materials and Methods:
From September 2002 to September 2017, database of the 403 patients of HCC that underwent LDLT was analysed and patients with HCC beyond the UCSF criteria were (n=176) were further studied for long-term outcome. At our center, only extrahepatic metastasis was considered absolute contraindication.The patients were categorized as per the degree of differentiation of the tumor on histopathological examination.
Results:
176 patients (43.67%) had the HCC beyond the criteria whereas 227 patients (56.32%)were within UCSF criteria. 5-year survival achieved in patients beyond UCSF was 48.68% versus 74.65% 5-year survival for patients within UCSF criteria 
.
The study cohort was further categorized depending upon the degree of differentiation of HCC. 78 patients (44.31%) had HCC that was well to moderately differentiated whereas in 98 patients (55.68%) the tumor HPE showed poorly differentiated HCC. 5-year survival for the well differentiated HCC patients was 69.08% where as the outcome was inferior in poorly differentiated HCC with a 33.99% 5-year survival. Patients with AFP >1000 ng/ml showed a dismal prognosis with a 5-year survival of only 21% patients. For the patients with AFP< 1000, the 5-year survival was 58%.
Conclusions:
Extended criteria for HCC in LDLT can achieve a modest long-term survival. features of biological tumor behaviour, such as tumor grading and vascular invasion have impact on recurrence of HCC after LDLT. Tumors with well differentiated morphology increases long-term survival even further for patients beyond the UCSF criteria.
CITATION INFORMATION: Thorat A., Jeng L.-B., Hsu S.-C., Yeh C.-C., Chen T.-H., Yang H.-R., Poon K.-S., Li P.-C. Living Donor Liver Transplantation for Hepatocellular Carcinoma beyond UCSF Criteria: Can We Achieve a Modest Long-Term Survival? A Single Center Retrospective Analysis of Using Extended Criteria Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Thorat A, Jeng L-B, Hsu S-C, Yeh C-C, Chen T-H, Yang H-R, Poon K-S, Li P-C. Living Donor Liver Transplantation for Hepatocellular Carcinoma beyond UCSF Criteria: Can We Achieve a Modest Long-Term Survival? A Single Center Retrospective Analysis of Using Extended Criteria [abstract]. https://atcmeetingabstracts.com/abstract/living-donor-liver-transplantation-for-hepatocellular-carcinoma-beyond-ucsf-criteria-can-we-achieve-a-modest-long-term-survival-a-single-center-retrospective-analysis-of-using-extended-criteria/. Accessed November 21, 2024.« Back to 2018 American Transplant Congress