Session Time: 5:30pm-6:30pm
Presentation Time: 5:30pm-6:30pm
Location: Exhibit Hall E
- Impact of Everolimus On the Hepatocellular Carcinoma Recurrence After Living Donor Liver Transplantation When Used in Early Stage: A Single Center Prospective Study
- Adoptive Immunotherapy With Liver Allograft-Derived NK Cells Improves Recurrence-Free Survival After Living-Donor Liver Transplantation in Patients With Hepatocellular Carcinoma
The use of partial liver grafts in the context of hepatocellular carcinoma (HCC) remains a matter of
debate because of a supposed higher risk of cancer recurrence compared to that of whole liver
grafting. We present a single center series of 161 adult recipients with HCC who underwent liver
transplantation (LT) over a 13 year period.
From december 1998 to july 2010, 161 LT were performed in patients with HCC. Of those, 8 died
during the 3 month period following LT and were excluded from the study. The remaining 153
patients were 125 males and 28 females with a mean age of 56 years. At the time of listing for LT,
29% and 12% of the tumors were radiologically classified Milan and UCSF out respectively. At the
time of transplantation, mean MELD score was 14.
LT were performed by using 39 (25%) partial grafts including 20 split grafts (17 right and 3 left
lobes) and 19 living donor grafts (18 right and 1 left lobes). On explants, HCC was found to be Milan
and UCSF out in 27% and 25% respectively. After a mean follow-up time of 83 months, overall
patient survival was 79% and HCC recurrence rate was 12%. In univariate analysis, there were no
significant differences between whole and partial LT for recipient age and gender, waiting time, MELD
score, pre-LT HCC treatment, HCC stages at the time of listing and on explants and HCC recurrence
(13% versus 5.1%, p=0.17). Nevertheless, donors were significantly younger in the partial graft
group than in the whole liver graft group (28 versus 47 years, p<0.0001) and overall patient survival
was much better in patients who had a partial graft compared to those with whole liver graft (94.9%
versus 73.6%, p=0.005). Overall recurrence-free patient survival was 87.6% ; it was 89.7% and
86.8% in partial and whole LT respectively (p=0.78).
In this series, the use of partial liver grafts for transplantation in patients with HCC was not
associated with increased HCC recurrence rate as compared to whole LT. Overall
survivals in patients who had partial LT were better than in those with whole liver
grafting. The role of young donors in this setting deserves further studies.
To cite this abstract in AMA style:Boillot O, Guillaud O, Dumortier J. Split and Living Donor Versus Whole Liver Transplantation for Hepatocellular Carcinoma in Adult Recipients: A Single Center Analysis [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/split-and-living-donor-versus-whole-liver-transplantation-for-hepatocellular-carcinoma-in-adult-recipients-a-single-center-analysis/. Accessed April 9, 2020.
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