期刊
AMERICAN JOURNAL OF TRANSPLANTATION
卷 7, 期 6, 页码 1601-1608出版社
WILEY
DOI: 10.1111/j.1600-6143.2007.01802.x
关键词
A2ALL; DDLT; HCC; LDLT; MELD; recurrence
资金
- NIDDK NIH HHS [U01 DK062531, U01 DK062531-07, U01 DK062531-01, U01 DK062531-04, U01 DK062536, U01 DK062496, U01 DK062531-08, U01 DK062531-05S1, U01 DK062467, U01 DK062483, U01 DK062498, U01 DK062531-03, U01 DK062444, U01 DK062531-08S1, U01 DK062505, U01 DK062484, U01 DK062531-07S1, U01 DK062531-02, U01 DK062531-09, U01 DK062494, U01 DK062531-10, U01 DK062531-05, U01 DK062531-06S1, U01 DK062531-06, U01 DK062531-09S1] Funding Source: Medline
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.
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