Outcomes of living and deceased donor liver transplant recipients with hepatocellular carcinoma: Results of the A2ALL Cohort

L. M. Kulik, R. A. Fisher*, D. R. Rodrigo, R. S. Brown, C. E. Freise, A. Shaked, J. E. Everhart, G. T. Everson, J. C. Hong, P. H. Hayashi, C. L. Berg, A. S F Lok

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

91 Scopus citations

Abstract

Hepatocellular carcinoma (HCC) represents an increasing fraction of liver transplant indications; the role of living donor liver transplant (LDLT) remains unclear. In the Adult-to-Adult Living Donor Liver Transplantation Cohort Study, patients with HCC and an LDLT or deceased donor liver transplant (DDLT) for which at least one potential living donor had been evaluated were compared for recurrence and posttransplant mortality rates. Mortality from date of evaluation of each recipient's first potential living donor was also analyzed. Unadjusted 5-year HCC recurrence was significantly higher after LDLT (38%) than DDLT (11%), (p = 0.0004). After adjustment for tumor characteristics, HCC recurrence remained significantly different between LDLT and DDLT recipients (hazard ratio (HR) = 2.35; p = 0.04) for the overall cohort but not for recipients transplanted following the introduction of MELD prioritization. Five-year posttransplant survival was similar in LDLT and DDLT recipients from time of transplant (HR = 1.32; p = 0.27) and from date of LDLT evaluation (HR = 0.73; p = 0.36). We conclude that the higher recurrence observed after LDLT is likely due to differences in tumor characteristics, pretransplant HCC management and waiting time.

Original languageEnglish (US)
Pages (from-to)2997-3007
Number of pages11
JournalAmerican Journal of Transplantation
Volume12
Issue number11
DOIs
StatePublished - Nov 2012

Keywords

  • HCC
  • MELD score
  • Milan criteria
  • loco-regional therapy
  • recurrence
  • survival

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

Fingerprint

Dive into the research topics of 'Outcomes of living and deceased donor liver transplant recipients with hepatocellular carcinoma: Results of the A2ALL Cohort'. Together they form a unique fingerprint.

Cite this