Extended Criteria for Living Donor Liver Transplantation in Patients With Advanced Hepatocellular Carcinoma

Choi, Ho Joong; Kim, D.G.; Na, G.H.; Hong, Tae Ho; You, Yong‐Ouk

doi:10.1016/j.transproceed.2012.01.019

Cited by 22 publications

(19 citation statements)

References 18 publications

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“…Therefore, Yao et al [19] proposed their own set of criteria, permitting the listing of patients with somewhat larger-sized tumors. In Asia, several independent criteria have also been proposed, expanding indications without increasing the risk of HCC recurrence significantly [20][21][22][23][24][25] ( Table 1). Five-year survival rates were as high as 80% after transplantation using these criteria.…”

Section: Surgical Therapiesmentioning

confidence: 99%

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Current management of hepatocellular carcinoma: An Eastern perspective

Yim¹

2015

WJG

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Section: Surgical Therapiesmentioning

confidence: 99%

“…April 7, 2015|Volume 21|Issue 13| WJG|www.wjgnet.com [23] ≤ 7 ≤ 7 NC 5 yr 86.3% Tokyo, Japan [24] ≤ 5 ≤ 5 NC 3 yr 82% 5 yr 75% Kyoto, Japan [25] ≤ 10 ≤ 5 PIVKA-II ≤ 400 mAU/mL 5 yr 87%…”

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confidence: 99%

Current management of hepatocellular carcinoma: An Eastern perspective

Yim¹

2015

WJG

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“…Choi et al (34) from the Catholic Medical Center further extended the eligibility criteria for LT to up to seven tumors with a maximum diameter of 7 cm or less. In their series, the 5-year overall and recurrence-free survival rates were 72% and 87%, respectively (34). Both criteria use only conventional morphological parameters, just as do the Milan and USCF criteria.…”

Section: Expanded Korean Criteria For Lt For Hccmentioning

confidence: 99%

Advancements of liver transplantation for hepatocellular carcinoma in Korea

Lee

Suh

2016

Japanese Journal of Clinical Oncology

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The Milan criteria are still considered the gold standard for patient selection criteria for liver transplantation in patients with hepatocellular carcinoma. However, those criteria may be too strict and thus exclude a significant number of patients who could benefit from liver transplantation. Based on this notion, many expanded selection criteria have been suggested. In Asian countries, where there is a serious shortage of deceased donor organs, living donor liver transplantation accounts for the majority of all liver transplant cases. Because living donor liver transplantation is not controlled by the public allocation system, the indications for living donor liver transplantation can be expanded. In Korea, living donor liver transplantation depends entirely on the discretion of the transplant team and the donor. Hence, Korean transplant centers have had a reasonable amount of experience with liver transplantation for advanced hepatocellular carcinoma. Experiences in Korea show that serum alpha-fetoprotein level, des-gamma-carboxy prothrombin level and positron emission tomography are very useful biomarkers in predicting tumor recurrence after transplantation. Tumors that show favorable levels of these biomarkers might not recur after transplantation despite being morphologically advanced. In addition, combination therapy with mammalian target of rapamycin inhibitors and sorafenib may improve survival even after tumor recurrence. Therefore, in Korea, living donor liver transplantation is considered even for cases of far advanced hepatocellular carcinoma if a recipient has no other effective treatment options and a well-informed donor wishes to willingly participate.

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“…With increasing experience in rescue LT of marginal donor grafts and living donor liver transplantation (LDLT), who are both independent from MELD-based allocation rules, it became evident in recent years that the MC are too rigid and very often unjustifiably preclude patients with beyond MC tumors from potentially curative treatment [13][14][15] . In order to increase the pool of eligible transplant patients, several expanded macromorphologic tumor selection criteria have been proposed, such as the University of California San Francisco (UCSF) and the registry based Up-to-seven (UTS) criteria [16][17][18] .…”

Section: Introductionmentioning

confidence: 99%

Liver transplantation for hepatocellular carcinoma - non-cancer factors and implications for improving outcome beyond standard tumor criteria

Kornberg¹,

Schernhammer²

2018

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How to cite this article: Kornberg A, Schernhammer M. Liver transplantation for hepatocellular carcinoma -non-cancer factors and implications for improving outcome beyond standard tumor criteria. Hepatoma Res 2018;4:60. http://dx. AbstractLiver transplantation (LT) is recognized as best treatment option in patients with early hepatocellular cancer (HCC) in underlying liver cirrhosis. Apart from tumor size and number implemented in the Milan criteria, which are current worldwide standards for patient selection, several biological tumor factors have been identified to affect cancer-specific outcome. In particular, grading and vascular tumor invasions were shown to correlate with aggressive biological tumor behavior and poor survival following LT. Identifying tumors with favorable biology is one important approach for expanding the pool of eligible liver recipients beyond the Milan burden limits. Improving the immunological state and condition for appropriate defense against circulating cancer cell attack may be another important prognostic aspect. Therefore, there is increasing interest in non-cancer factors related to the peritransplant period that may influence the oncological outcome by providing negative immunomodulatory actions. Considering and modulation of these non-HCC factors of prognosis might contribute in safely expanding the HCC LT selection criteria.

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Extended Criteria for Living Donor Liver Transplantation in Patients With Advanced Hepatocellular Carcinoma

Cited by 22 publications

References 18 publications

Current management of hepatocellular carcinoma: An Eastern perspective

Current management of hepatocellular carcinoma: An Eastern perspective

Advancements of liver transplantation for hepatocellular carcinoma in Korea

Liver transplantation for hepatocellular carcinoma - non-cancer factors and implications for improving outcome beyond standard tumor criteria

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