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2008 Annual Meeting Abstracts


Outcome of living donor liver transplantation for hepatocellular carcinoma
Khashayar Vakili, M.D., James Pomposelli, M.D., Ph.D., Kenneth J. McPartland, M.D., William D. Lewis, M.D., Fredric D. Gordon, M.D., Maryann Simpson, Ph.D., Roger L. Jenkins, M.D., Elizabeth A. Pomfret, M.D., Ph.D..
Lahey Clinic Medical Center, Burlington, MA, USA.

Purpose:Our aim was to assess rate of recurrence and long-term survival in patients undergoing LDLT and deceased donor (DDLT) liver transplantation for HCC and to identify prognostic indicators for tumor recurrence.
Methods:The records of 104 patients who had undergone liver transplantation (LT) for HCC from 1999-2007 were reviewed. Twenty-eight patients underwent LDLT and 76 underwent DDLT. Mean age, MELD scores, median tumor size, and macrovascular invasion were compared.
Results:
AgeMELDRecurrence*Tumor size*
DDLT55.1±0.7813.2±0.89.2%2.7±1.7
LDLT56±1.111.2±1.228.6%3.3±1.3

*(p<0.05)
While macrovascular invasion was not associated with recurrence in the DDLT group (p=0.11), it was significantly associated with recurrence in the LDLT group (p=0.017).The difference in overall survival between the two groups was not statistically significant (Fig. 1, p=0.058). The survival of DDLT(n=69) and LDLT(n=20) patients who did not have recurrence at 6 years was 62.3% and 100% respectively (Fig.2, p=0.013).
Conclusion: 1)Despite increased median tumor size, presence of macrovascular invasion and tumor recurrence in patients undergoing LDLT, 3 and 6-year survival was not different from DDLT. 2)LDLT in patients with HCC offers superior survival in those without recurrence and a trend (p=0.058) for improved overall survival compared to DDLT. 3) Concerns regarding increased mortality in patients undergoing LDLT for HCC appear unwarranted.


 

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