BACKGROUND: Studies evaluating liver transplantation (LT) in hepatocellular carcinoma (HCC) in the Middle East have been scarce, mainly due to intricacy of this type of surgery. OBJECTIVE: In here we report our experiences with LT among patients with HCC cirrhosis. Methods: All patients who underwent LT with primary diagnosis of HCC older than 18 years old, during 2004 to 2019, were initially included in our study. RESULTS: Overall, 124 patients entered our study, among which majority were males (86.3%). Mean (SD) age of patients was 53.1±10.6 years old. Most common underlying liver diseases were HBV (55.6%) and HCV infections (12.1%). Mean MELD score of patients was 18±5.5. Child-Pugh score of most patients was class B (50%). Mean (SD) duration of hospitalization was 12.1±3.5 days. Patients were followed for a median of 32 (9, 62) months. The most common causes of death were recurrence of HCC (47.7%) and sepsis (34.1%). Median (IQR) duration to recurrence and death were 18 (4, 34) months and 17.5 (5.7, 44.5) months, respectively. One-year survival (89%, 86.4%, and 63.2%, respectively) (p=0.011) and one-year DFS (89%, 86.4%, and 57.9%, respectively) (p=0.001) was significant different between those who were selected based on the Milan, UCSF and extended criteria. CONCLUSION: Our study provides valuable experiences on LT and HCC from one of the largest LT centers in the world. Accordingly, we found that the Milan criterion provides the best survival compared to the UCSF and our extended criteria for patient selection.
BACKGROUND: Studies evaluating liver transplantation (LT) in hepatocellular carcinoma (HCC) in the Middle East have been scarce, mainly due to intricacy of this type of surgery. OBJECTIVE: In here we report our experiences with LT among patients with HCC cirrhosis. Methods: All patients who underwent LT with primary diagnosis of HCC older than 18 years old, during 2004 to 2019, were initially included in our study. RESULTS: Overall, 124 patients entered our study, among which majority were males (86.3%). Mean (SD) age of patients was 53.1±10.6 years old. Most common underlying liver diseases were HBV (55.6%) and HCV infections (12.1%). Mean MELD score of patients was 18±5.5. Child-Pugh score of most patients was class B (50%). Mean (SD) duration of hospitalization was 12.1±3.5 days. Patients were followed for a median of 32 (9, 62) months. The most common causes of death were recurrence of HCC (47.7%) and sepsis (34.1%). Median (IQR) duration to recurrence and death were 18 (4, 34) months and 17.5 (5.7, 44.5) months, respectively. One-year survival (89%, 86.4%, and 63.2%, respectively) (p=0.011) and one-year DFS (89%, 86.4%, and 57.9%, respectively) (p=0.001) was significant different between those who were selected based on the Milan, UCSF and extended criteria. CONCLUSION: Our study provides valuable experiences on LT and HCC from one of the largest LT centers in the world. Accordingly, we found that the Milan criterion provides the best survival compared to the UCSF and our extended criteria for patient selection.
Authors: René Adam; Vincent Karam; Valérie Cailliez; John G O Grady; Darius Mirza; Daniel Cherqui; Jurgen Klempnauer; Mauro Salizzoni; Johann Pratschke; Neville Jamieson; Ernest Hidalgo; Andreas Paul; Rafael Lopez Andujar; Jan Lerut; Lutz Fisher; Karim Boudjema; Constantino Fondevila; Olivier Soubrane; Philippe Bachellier; Antonio D Pinna; Gabriela Berlakovich; William Bennet; Massimo Pinzani; Peter Schemmer; Krzysztof Zieniewicz; Carlos Jimenez Romero; Paolo De Simone; Bo-Goran Ericzon; Stefan Schneeberger; Stephen J Wigmore; Joan Fabregat Prous; Michele Colledan; Robert J Porte; Sezai Yilmaz; Daniel Azoulay; Jacques Pirenne; Pal-Dag Line; Pavel Trunecka; Francis Navarro; Andres Valdivieso Lopez; Luciano De Carlis; Sebastian Rufian Pena; Eberhard Kochs; Christophe Duvoux Journal: Transpl Int Date: 2018-12 Impact factor: 3.782
Authors: Josep M Llovet; Mihai Pavel; Jordi Rimola; Maria Alba Diaz; Jordi Colmenero; David Saavedra-Perez; Constantino Fondevila; Carmen Ayuso; Josep Fuster; Pere Ginès; Jordi Bruix; Juan Carlos Garcia-Valdecasas Journal: Liver Transpl Date: 2018-03 Impact factor: 5.799
Authors: Markus B Schoenberg; Julian N Bucher; Adrian Vater; Alexandr V Bazhin; Jingcheng Hao; Markus O Guba; Martin K Angele; Jens Werner; Markus Rentsch Journal: Dtsch Arztebl Int Date: 2017-08-07 Impact factor: 5.594
Authors: V Müller; T Förtsch; M Gündel; R S Croner; M Langheinrich; S Yedibela; C Lohmüller; M Küffner; W Hohenberger; A Perrakis Journal: Transplant Proc Date: 2013-06 Impact factor: 1.066
Authors: A Vogel; A Cervantes; I Chau; B Daniele; J M Llovet; T Meyer; J-C Nault; U Neumann; J Ricke; B Sangro; P Schirmacher; C Verslype; C J Zech; D Arnold; E Martinelli Journal: Ann Oncol Date: 2018-10-01 Impact factor: 32.976
Authors: V Mazzaferro; E Regalia; R Doci; S Andreola; A Pulvirenti; F Bozzetti; F Montalto; M Ammatuna; A Morabito; L Gennari Journal: N Engl J Med Date: 1996-03-14 Impact factor: 176.079