Zhenhua Hu1, Ze Qian1, Jian Wu1, Jie Zhou1, Min Zhang1, Lin Zhou1, Shusen Zheng2. 1. Zhejiang University, School of Medicine, First Affiliated Hospital, Department of Hepatobiliary and Pancreatic Surgery, Hangzhou, China; Zhejiang University, School of Medicine, First Affiliated Hospital, Ministry of Public Health, Key Laboratory of Combined Multi-Organ Transplantation, Hangzhou, China; Zhejiang University, College of Medicine, The First Affiliated Hospital, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, 310003 Hangzhou, China. 2. Zhejiang University, School of Medicine, First Affiliated Hospital, Department of Hepatobiliary and Pancreatic Surgery, Hangzhou, China; Zhejiang University, School of Medicine, First Affiliated Hospital, Ministry of Public Health, Key Laboratory of Combined Multi-Organ Transplantation, Hangzhou, China; Zhejiang University, College of Medicine, The First Affiliated Hospital, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, 310003 Hangzhou, China. Electronic address: shusenzheng@zju.edu.cn.
Abstract
BACKGROUND: The different outcomes of deceased donor liver transplantation (DDLT) and living donor liver transplantation (LDLT) for hepatocellular carcinoma (HCC) are currently being debated. We aimed to retrospectively compare the outcomes following LDLT and DDLT and to analyse the factors influencing this. METHODS: We compared the overall survival (OS) and disease-free survival (DFS) rates of HCC patients after LDLT (n=389) and DDLT (n=6471) from 81 centres over a 10-year period. OS and DFS rates were calculated with the Kaplan-Meier method. And univariate and multivariate Cox proportional hazards regressions were performed on the entire cohort to identify predictors. RESULTS: Of 6860 patients, the 1-, 3-, and 5-year OS rates were 86.79%, 70.16%, and 66.31% after LDLT, respectively, and 74.2%, 54.21%, and 46.97% after DDLT, respectively (P<0.001). The 1-, 3-, and 5-year DFS rates were 78.46%, 63.68%, and 61.63% after LDLT, respectively, and 65.65%, 48.61%, and 41.87% after DDLT, respectively (P<0.001). The multivariate Cox regression model determined that the DFS and OS of HCC patients post-liver transplantation (LT) were strongly associated with tumour morphology and biology, but not graft type. CONCLUSIONS: With regards to OS and DFS, there were no disadvantages to LDLT as compared with DDLT; tumour morphology and biology may affect the prognosis of LT.
BACKGROUND: The different outcomes of deceased donor liver transplantation (DDLT) and living donor liver transplantation (LDLT) for hepatocellular carcinoma (HCC) are currently being debated. We aimed to retrospectively compare the outcomes following LDLT and DDLT and to analyse the factors influencing this. METHODS: We compared the overall survival (OS) and disease-free survival (DFS) rates of HCC patients after LDLT (n=389) and DDLT (n=6471) from 81 centres over a 10-year period. OS and DFS rates were calculated with the Kaplan-Meier method. And univariate and multivariate Cox proportional hazards regressions were performed on the entire cohort to identify predictors. RESULTS: Of 6860 patients, the 1-, 3-, and 5-year OS rates were 86.79%, 70.16%, and 66.31% after LDLT, respectively, and 74.2%, 54.21%, and 46.97% after DDLT, respectively (P<0.001). The 1-, 3-, and 5-year DFS rates were 78.46%, 63.68%, and 61.63% after LDLT, respectively, and 65.65%, 48.61%, and 41.87% after DDLT, respectively (P<0.001). The multivariate Cox regression model determined that the DFS and OS of HCC patients post-liver transplantation (LT) were strongly associated with tumour morphology and biology, but not graft type. CONCLUSIONS: With regards to OS and DFS, there were no disadvantages to LDLT as compared with DDLT; tumour morphology and biology may affect the prognosis of LT.
Authors: Rafael S Pinheiro; Daniel R Waisberg; Lucas S Nacif; Vinicius Rocha-Santos; Rubens M Arantes; Liliana Ducatti; Rodrigo B Martino; Quirino Lai; Wellington Andraus; Luiz A C D'Albuquerque Journal: Transl Gastroenterol Hepatol Date: 2017-08-29