Rare Malignant Indications for Liver Transplantation: A Collaborative Transplant Study Report

Introduction: Hepatocellular carcinoma (HCC) is by far the leading malignant indication for liver transplantation (LT). Few other malignancies, including cholangiocellular carcinoma (CCC), metastases from neuroendocrine tumors (NET), and sarcomas of the liver (LSAR), also are commonly accepted indic...

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Autores principales:	Philipp Houben, Simon Schimmack, Christian Unterrainer, Bernd Döhler, Arianeb Mehrabi, Caner Süsal
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	liver transplantation transplant oncology hepatocellular carcinoma cholangiocellular carcinoma neuroendocrine tumor liver sarcoma liver transplantation for rare malignancies Surgery RD1-811
Acceso en línea:	https://doaj.org/article/d4d00917443b4a05b9abb70a5b6550d5
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spelling	oai:doaj.org-article:d4d00917443b4a05b9abb70a5b6550d52021-12-03T05:20:59ZRare Malignant Indications for Liver Transplantation: A Collaborative Transplant Study Report2296-875X10.3389/fsurg.2021.678392https://doaj.org/article/d4d00917443b4a05b9abb70a5b6550d52021-12-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fsurg.2021.678392/fullhttps://doaj.org/toc/2296-875XIntroduction: Hepatocellular carcinoma (HCC) is by far the leading malignant indication for liver transplantation (LT). Few other malignancies, including cholangiocellular carcinoma (CCC), metastases from neuroendocrine tumors (NET), and sarcomas of the liver (LSAR), also are commonly accepted indications for LT. However, there is limited information on their outcome after LT.Methods: Graft and patient survival in 14,623 LTs performed in patients with hepatocellular carcinoma, CCC, NET, and LSAR from 1988 to 2017 and reported to the Collaborative Transplant Study were analyzed.Results: The study group consisted of 13,862 patients who had HCC (94.8%), 498 (3.4%) who had CCC, 100 (0.7%) who had NET, and 163 (1.1%) who had LSAR. CCC patients showed a 5-year graft survival rate of 32.1%, strikingly lower than the 63.2% rate in HCC, 51.6% rate in NET, and 64.5% rate in LSAR patients (P < 0.001 for all vs. CCC). Multivariable Cox regression analysis revealed a significantly higher risk of graft loss and death due to cancer during the first five post-transplant years in CCC vs. HCC patients (HR 1.77 and 2.56; P < 0.001 for both). The same risks were increased also in NET and LSAR patients but did not reach statistical significance.Conclusion: Among patients with rare malignant indications for LT, CCC patients showed significantly impaired graft as well as patient survival compared to HCC patients. The observed differences might challenge traditional decision-making processes for LT indication and palliative treatment in specific hepatic malignancies.Philipp HoubenSimon SchimmackChristian UnterrainerBernd DöhlerArianeb MehrabiCaner SüsalCaner SüsalFrontiers Media S.A.articleliver transplantationtransplant oncologyhepatocellular carcinomacholangiocellular carcinomaneuroendocrine tumorliver sarcoma liver transplantation for rare malignanciesSurgeryRD1-811ENFrontiers in Surgery, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	liver transplantation transplant oncology hepatocellular carcinoma cholangiocellular carcinoma neuroendocrine tumor liver sarcoma liver transplantation for rare malignancies Surgery RD1-811
spellingShingle	liver transplantation transplant oncology hepatocellular carcinoma cholangiocellular carcinoma neuroendocrine tumor liver sarcoma liver transplantation for rare malignancies Surgery RD1-811 Philipp Houben Simon Schimmack Christian Unterrainer Bernd Döhler Arianeb Mehrabi Caner Süsal Caner Süsal Rare Malignant Indications for Liver Transplantation: A Collaborative Transplant Study Report
description	Introduction: Hepatocellular carcinoma (HCC) is by far the leading malignant indication for liver transplantation (LT). Few other malignancies, including cholangiocellular carcinoma (CCC), metastases from neuroendocrine tumors (NET), and sarcomas of the liver (LSAR), also are commonly accepted indications for LT. However, there is limited information on their outcome after LT.Methods: Graft and patient survival in 14,623 LTs performed in patients with hepatocellular carcinoma, CCC, NET, and LSAR from 1988 to 2017 and reported to the Collaborative Transplant Study were analyzed.Results: The study group consisted of 13,862 patients who had HCC (94.8%), 498 (3.4%) who had CCC, 100 (0.7%) who had NET, and 163 (1.1%) who had LSAR. CCC patients showed a 5-year graft survival rate of 32.1%, strikingly lower than the 63.2% rate in HCC, 51.6% rate in NET, and 64.5% rate in LSAR patients (P < 0.001 for all vs. CCC). Multivariable Cox regression analysis revealed a significantly higher risk of graft loss and death due to cancer during the first five post-transplant years in CCC vs. HCC patients (HR 1.77 and 2.56; P < 0.001 for both). The same risks were increased also in NET and LSAR patients but did not reach statistical significance.Conclusion: Among patients with rare malignant indications for LT, CCC patients showed significantly impaired graft as well as patient survival compared to HCC patients. The observed differences might challenge traditional decision-making processes for LT indication and palliative treatment in specific hepatic malignancies.
format	article
author	Philipp Houben Simon Schimmack Christian Unterrainer Bernd Döhler Arianeb Mehrabi Caner Süsal Caner Süsal
author_facet	Philipp Houben Simon Schimmack Christian Unterrainer Bernd Döhler Arianeb Mehrabi Caner Süsal Caner Süsal
author_sort	Philipp Houben
title	Rare Malignant Indications for Liver Transplantation: A Collaborative Transplant Study Report
title_short	Rare Malignant Indications for Liver Transplantation: A Collaborative Transplant Study Report
title_full	Rare Malignant Indications for Liver Transplantation: A Collaborative Transplant Study Report
title_fullStr	Rare Malignant Indications for Liver Transplantation: A Collaborative Transplant Study Report
title_full_unstemmed	Rare Malignant Indications for Liver Transplantation: A Collaborative Transplant Study Report
title_sort	rare malignant indications for liver transplantation: a collaborative transplant study report
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/d4d00917443b4a05b9abb70a5b6550d5
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Rare Malignant Indications for Liver Transplantation: A Collaborative Transplant Study Report

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