Living donor liver transplantation for hepatocellular carcinoma beyond the Milan criteria: outcome of expanded criteria in tumor size

Abstract Background The Milan criteria are the universal standard of liver transplantation for hepatocellular carcinoma (HCC). Numerous expanded criteria have shown outcomes as good as the Milan criteria. In Taiwan, living donor liver transplant (LDLT) accounts for the majority of transplantations d...

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Autores principales:	Hsin-Rou Liang, Chia-En Hsieh, Kuo-Hua Lin, Chih-Jan Ko, Yu-Ju Hung, Ya-Lan Hsu, Yao-Li Chen
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Living donor liver transplantation Hepatocellular carcinoma Beyond the Milan criteria Surgery RD1-811
Acceso en línea:	https://doaj.org/article/d5341698ebef4a70803c83a1ac79659b
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spelling	oai:doaj.org-article:d5341698ebef4a70803c83a1ac79659b2021-11-21T12:05:54ZLiving donor liver transplantation for hepatocellular carcinoma beyond the Milan criteria: outcome of expanded criteria in tumor size10.1186/s12893-021-01403-z1471-2482https://doaj.org/article/d5341698ebef4a70803c83a1ac79659b2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12893-021-01403-zhttps://doaj.org/toc/1471-2482Abstract Background The Milan criteria are the universal standard of liver transplantation for hepatocellular carcinoma (HCC). Numerous expanded criteria have shown outcomes as good as the Milan criteria. In Taiwan, living donor liver transplant (LDLT) accounts for the majority of transplantations due to organ shortages. Methods We retrospectively enrolled 155 patients who underwent LDLT for HCC from July 2005 to June 2017 and were followed up for at least 2 years. Patients beyond the Milan criteria (n = 78) were grouped as recurrent or nonrecurrent, and we established new expanded criteria based on these data. Results Patients beyond the Milan criteria with recurrence (n = 31) had a significantly larger maximal tumor diameter (4.13 ± 1.96 cm versus 6.10 ± 3.41 cm, p = 0.006) and total tumor diameter (7.19 ± 4.13 cm versus 10.21 ± 5.01 cm, p = 0.005). Therefore, we established expanded criteria involving maximal tumor diameter ≤ 6 cm and total tumor diameter < 10 cm. The 5-year survival rate of patients who met these criteria (n = 134) was 77.3%, and the 5-year recurrence rate was 20.5%; both showed no significant differences from those of the Milan criteria. Under the expanded criteria, the pool of eligible recipients was 35% larger than that of the Milan criteria. Conclusion Currently, patients with HCC who undergo LDLT can achieve good outcomes even when they are beyond the Milan criteria. Under the new expanded criteria, patients can achieve outcomes as good as those with the Milan criteria and more patients can benefit.Hsin-Rou LiangChia-En HsiehKuo-Hua LinChih-Jan KoYu-Ju HungYa-Lan HsuYao-Li ChenBMCarticleLiving donor liver transplantationHepatocellular carcinomaBeyond the Milan criteriaSurgeryRD1-811ENBMC Surgery, Vol 21, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Living donor liver transplantation Hepatocellular carcinoma Beyond the Milan criteria Surgery RD1-811
spellingShingle	Living donor liver transplantation Hepatocellular carcinoma Beyond the Milan criteria Surgery RD1-811 Hsin-Rou Liang Chia-En Hsieh Kuo-Hua Lin Chih-Jan Ko Yu-Ju Hung Ya-Lan Hsu Yao-Li Chen Living donor liver transplantation for hepatocellular carcinoma beyond the Milan criteria: outcome of expanded criteria in tumor size
description	Abstract Background The Milan criteria are the universal standard of liver transplantation for hepatocellular carcinoma (HCC). Numerous expanded criteria have shown outcomes as good as the Milan criteria. In Taiwan, living donor liver transplant (LDLT) accounts for the majority of transplantations due to organ shortages. Methods We retrospectively enrolled 155 patients who underwent LDLT for HCC from July 2005 to June 2017 and were followed up for at least 2 years. Patients beyond the Milan criteria (n = 78) were grouped as recurrent or nonrecurrent, and we established new expanded criteria based on these data. Results Patients beyond the Milan criteria with recurrence (n = 31) had a significantly larger maximal tumor diameter (4.13 ± 1.96 cm versus 6.10 ± 3.41 cm, p = 0.006) and total tumor diameter (7.19 ± 4.13 cm versus 10.21 ± 5.01 cm, p = 0.005). Therefore, we established expanded criteria involving maximal tumor diameter ≤ 6 cm and total tumor diameter < 10 cm. The 5-year survival rate of patients who met these criteria (n = 134) was 77.3%, and the 5-year recurrence rate was 20.5%; both showed no significant differences from those of the Milan criteria. Under the expanded criteria, the pool of eligible recipients was 35% larger than that of the Milan criteria. Conclusion Currently, patients with HCC who undergo LDLT can achieve good outcomes even when they are beyond the Milan criteria. Under the new expanded criteria, patients can achieve outcomes as good as those with the Milan criteria and more patients can benefit.
format	article
author	Hsin-Rou Liang Chia-En Hsieh Kuo-Hua Lin Chih-Jan Ko Yu-Ju Hung Ya-Lan Hsu Yao-Li Chen
author_facet	Hsin-Rou Liang Chia-En Hsieh Kuo-Hua Lin Chih-Jan Ko Yu-Ju Hung Ya-Lan Hsu Yao-Li Chen
author_sort	Hsin-Rou Liang
title	Living donor liver transplantation for hepatocellular carcinoma beyond the Milan criteria: outcome of expanded criteria in tumor size
title_short	Living donor liver transplantation for hepatocellular carcinoma beyond the Milan criteria: outcome of expanded criteria in tumor size
title_full	Living donor liver transplantation for hepatocellular carcinoma beyond the Milan criteria: outcome of expanded criteria in tumor size
title_fullStr	Living donor liver transplantation for hepatocellular carcinoma beyond the Milan criteria: outcome of expanded criteria in tumor size
title_full_unstemmed	Living donor liver transplantation for hepatocellular carcinoma beyond the Milan criteria: outcome of expanded criteria in tumor size
title_sort	living donor liver transplantation for hepatocellular carcinoma beyond the milan criteria: outcome of expanded criteria in tumor size
publisher	BMC
publishDate	2021
url	https://doaj.org/article/d5341698ebef4a70803c83a1ac79659b
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Living donor liver transplantation for hepatocellular carcinoma beyond the Milan criteria: outcome of expanded criteria in tumor size

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