AIM: To examine the results of orthotopic liver transplantation (OLT) for hepatocellular carcinoma (HCC) in Ireland over a 14-year period. METHODS: Cases of HCC receiving OLT between January 1995 and September 2009 in the Irish Liver Transplant Unit were reviewed from a prospectively maintained database. Outcome measures included overall and recurrence free survival, alpha-fetoprotein (AFP) and tumour pathological features. RESULTS: On explant pathology, 57 patients had HCC. The median follow-up time was 42.7 mo. The overall 1, 3 and 5 years survival was 87.7%, 72.1% and 72.4%. There was no difference in survival when compared to patients undergoing OLT without malignancy. The tumour recurrence rate was 14%. The Milan criteria were exceeded in 32% of cases but this did not predict overall survival or recurrence. On multivariate analysis pre-operative AFP > 100 ng/mL was an independent risk factor for recurrence (RR = 5.2, CI: 1.1-24.3, P = 0.036). CONCLUSION: Patients undergoing OLT for HCC had excellent survival even when conventional listing criteria were exceeded. Pre-operative AFP predicts recurrence independent of tumour size and its role in selection criteria should be investigated in larger studies.
AIM: To examine the results of orthotopic liver transplantation (OLT) for hepatocellular carcinoma (HCC) in Ireland over a 14-year period. METHODS: Cases of HCC receiving OLT between January 1995 and September 2009 in the Irish Liver Transplant Unit were reviewed from a prospectively maintained database. Outcome measures included overall and recurrence free survival, alpha-fetoprotein (AFP) and tumour pathological features. RESULTS: On explant pathology, 57 patients had HCC. The median follow-up time was 42.7 mo. The overall 1, 3 and 5 years survival was 87.7%, 72.1% and 72.4%. There was no difference in survival when compared to patients undergoing OLT without malignancy. The tumour recurrence rate was 14%. The Milan criteria were exceeded in 32% of cases but this did not predict overall survival or recurrence. On multivariate analysis pre-operative AFP > 100 ng/mL was an independent risk factor for recurrence (RR = 5.2, CI: 1.1-24.3, P = 0.036). CONCLUSION:Patients undergoing OLT for HCC had excellent survival even when conventional listing criteria were exceeded. Pre-operative AFP predicts recurrence independent of tumour size and its role in selection criteria should be investigated in larger studies.
Authors: David M Levi; Andreas G Tzakis; Paul Martin; Seigo Nishida; Eddie Island; Jang Moon; Gennaro Selvaggi; Akin Tekin; Beatrice L Madrazo; Govindarajan Narayanan; Monica T Garcia; Lynn G Feun; Panagiotis Tryphonopoulos; Nikolaos Skartsis; Alan S Livingstone Journal: J Am Coll Surg Date: 2010-05 Impact factor: 6.113
Authors: F Y Yao; L Ferrell; N M Bass; J J Watson; P Bacchetti; A Venook; N L Ascher; J P Roberts Journal: Hepatology Date: 2001-06 Impact factor: 17.425
Authors: M B Zaman; E Hoti; A Qasim; D Maguire; P A McCormick; J E Hegarty; J G Geoghegan; O Traynor Journal: Transplant Proc Date: 2006-09 Impact factor: 1.066
Authors: S Jonas; W O Bechstein; T Steinmüller; M Herrmann; C Radke; T Berg; U Settmacher; P Neuhaus Journal: Hepatology Date: 2001-05 Impact factor: 17.425
Authors: Matteo Cescon; Matteo Ravaioli; Gian Luca Grazi; Giorgio Ercolani; Alessandro Cucchetti; Valentina Bertuzzo; Gaetano Vetrone; Massimo Del Gaudio; Marco Vivarelli; Antonietta D'Errico-Grigioni; Alessandro Dazzi; Paolo Di Gioia; Augusto Lauro; Antonio Daniele Pinna Journal: J Transplant Date: 2010-08-25
Authors: Francesco D'Amico; Myron Schwartz; Alessandro Vitale; Parissa Tabrizian; Sasan Roayaie; Swan Thung; Maria Guido; Juan del Rio Martin; Thomas Schiano; Umberto Cillo Journal: Liver Transpl Date: 2009-10 Impact factor: 5.799