Liver transplantation for hepatocellular carcinoma using grafts from uncontrolled circulatory death donation

Abstract Controversy exists regarding whether the rate of hepatocellular carcinoma (HCC) recurrence after orthotopic liver transplantation (OLT) differs when using livers from donation after controlled circulatory death (DCD) versus livers from donation after brain death (DBD). The aim of this cohor...

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Autores principales:	Anisa Nutu, Iago Justo, Alberto Marcacuzco, Óscar Caso, Alejandro Manrique, Jorge Calvo, Álvaro García-Sesma, María García-Conde, María Santos Gallego, Carlos Jiménez-Romero
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/b904ea0fc4aa461fb9f560ce33574508
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spelling	oai:doaj.org-article:b904ea0fc4aa461fb9f560ce335745082021-12-02T14:33:57ZLiver transplantation for hepatocellular carcinoma using grafts from uncontrolled circulatory death donation10.1038/s41598-021-92976-52045-2322https://doaj.org/article/b904ea0fc4aa461fb9f560ce335745082021-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-92976-5https://doaj.org/toc/2045-2322Abstract Controversy exists regarding whether the rate of hepatocellular carcinoma (HCC) recurrence after orthotopic liver transplantation (OLT) differs when using livers from donation after controlled circulatory death (DCD) versus livers from donation after brain death (DBD). The aim of this cohort study was to analyze rates of HCC recurrence, patient survival, and graft survival after OLT for HCC, comparing recipients of DBD livers (n = 103) with recipients of uncontrolled DCD livers (uDCD; n = 41). No significant differences in tumor size, tumor number, serum alpha-fetoprotein, proportion of patients within Milan criteria, or pre-OLT bridging therapies were identified between groups, although the waitlist period was significantly shorter in the uDCD group (p = 0.040). HCC recurrence was similar between groups. Patient survival was similar between groups, but graft survival was lower in the uDCD group. Multivariate analysis identified recipient age (p = 0.031), pre-OLT bridging therapy (p = 0.024), and HCC recurrence (p = 0.048) as independent risk factors for patient survival and pre-OLT transarterial chemoembolization (p = 0.045) as the single risk factor for HCC recurrence. In conclusion, similar patient survival and lower graft survival were observed in the uDCD group. However, the use of uDCD livers appears to be justified due to a shorter waitlist time, and lower waitlist dropout and HCC recurrence rates.Anisa NutuIago JustoAlberto MarcacuzcoÓscar CasoAlejandro ManriqueJorge CalvoÁlvaro García-SesmaMaría García-CondeMaría Santos GallegoCarlos Jiménez-RomeroNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Anisa Nutu Iago Justo Alberto Marcacuzco Óscar Caso Alejandro Manrique Jorge Calvo Álvaro García-Sesma María García-Conde María Santos Gallego Carlos Jiménez-Romero Liver transplantation for hepatocellular carcinoma using grafts from uncontrolled circulatory death donation
description	Abstract Controversy exists regarding whether the rate of hepatocellular carcinoma (HCC) recurrence after orthotopic liver transplantation (OLT) differs when using livers from donation after controlled circulatory death (DCD) versus livers from donation after brain death (DBD). The aim of this cohort study was to analyze rates of HCC recurrence, patient survival, and graft survival after OLT for HCC, comparing recipients of DBD livers (n = 103) with recipients of uncontrolled DCD livers (uDCD; n = 41). No significant differences in tumor size, tumor number, serum alpha-fetoprotein, proportion of patients within Milan criteria, or pre-OLT bridging therapies were identified between groups, although the waitlist period was significantly shorter in the uDCD group (p = 0.040). HCC recurrence was similar between groups. Patient survival was similar between groups, but graft survival was lower in the uDCD group. Multivariate analysis identified recipient age (p = 0.031), pre-OLT bridging therapy (p = 0.024), and HCC recurrence (p = 0.048) as independent risk factors for patient survival and pre-OLT transarterial chemoembolization (p = 0.045) as the single risk factor for HCC recurrence. In conclusion, similar patient survival and lower graft survival were observed in the uDCD group. However, the use of uDCD livers appears to be justified due to a shorter waitlist time, and lower waitlist dropout and HCC recurrence rates.
format	article
author	Anisa Nutu Iago Justo Alberto Marcacuzco Óscar Caso Alejandro Manrique Jorge Calvo Álvaro García-Sesma María García-Conde María Santos Gallego Carlos Jiménez-Romero
author_facet	Anisa Nutu Iago Justo Alberto Marcacuzco Óscar Caso Alejandro Manrique Jorge Calvo Álvaro García-Sesma María García-Conde María Santos Gallego Carlos Jiménez-Romero
author_sort	Anisa Nutu
title	Liver transplantation for hepatocellular carcinoma using grafts from uncontrolled circulatory death donation
title_short	Liver transplantation for hepatocellular carcinoma using grafts from uncontrolled circulatory death donation
title_full	Liver transplantation for hepatocellular carcinoma using grafts from uncontrolled circulatory death donation
title_fullStr	Liver transplantation for hepatocellular carcinoma using grafts from uncontrolled circulatory death donation
title_full_unstemmed	Liver transplantation for hepatocellular carcinoma using grafts from uncontrolled circulatory death donation
title_sort	liver transplantation for hepatocellular carcinoma using grafts from uncontrolled circulatory death donation
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/b904ea0fc4aa461fb9f560ce33574508
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Liver transplantation for hepatocellular carcinoma using grafts from uncontrolled circulatory death donation

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