Abstract
Background/aimWith the increased experience in living donor liver transplantation (LDLT), it has been adopted for the treatment of hepatocellular carcinoma (HCC), with emerging discussions of criteria beyond tumor size and number. In contrast to deceased donor liver transplantation (DDLT), recipient selection for LDLT is not limited by organ allocation systems. We discuss herein the assessment, criteria, and experience with liver transplantation (LT) in HCC cases at a high-volume LDLT center.Material and methods: Between August 2006 and December 2017, 191 adult LT HCC recipients with at least one-year follow-up were retrospectively analyzed.Results In 191 patients, one-, three- and five-year survival rates were 87.2%, 81.6%, and 76.2%, respectively, including early postoperative mortality. In 174 patients with long-term follow-up, one-, three- and five-year disease-free survival rates were 91.6%, 87.7%, and 84.4%, respectively. When multivariate analysis was utilized, tumor differentiation was the only factor which statistically affected survival (p = 0.025). Conclusion LDLT allows us to push the limits forward and the question “Are the criteria always right?” is always on the table. We can conclude that, with the advantage of LDLT, every HCC patient deserves a case-by-case basis discussion for LT under scientific literature support. In borderline cases, tumor biopsy might help determine the decision for LT.
Highlights
Hepatocellular carcinoma (HCC) is the most common primary liver cancer and remains an ongoing problem, with incidence increasing worldwide
In contrast to deceased donor liver transplantation (DDLT), recipient selection for living donor transplantation (LDLT) is not limited by organ allocation systems
Tumor biopsy might help determine the decision for LT
Summary
Hepatocellular carcinoma (HCC) is the most common primary liver cancer and remains an ongoing problem, with incidence increasing worldwide. Surgical resection and interventional radiological treatment are the options with successful outcomes in limited cases due to underlying chronic liver disease. Liver transplantation (LT) became a radical treatment for HCC in that it can simultaneously treat intrahepatic metastasis as well as multicentric carcinogenesis and diseased liver [4,5,6]. During the last two decades, Milan Criteria (MC) has been implemented worldwide for LT in cases of HCC, and many organ sharing programs use MC for organ allocation. With increased experience in living donor transplantation (LDLT), LDLT was adopted in the setting of HCC treatment with new discussions about criteria beyond the size and number of tumors. In contrast to deceased donor liver transplantation (DDLT), recipient selection for LDLT is not limited by organ allocation systems
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
