Expansion of the criteria for living donor liver transplantation for hepatocellular carcinoma

Research output: Contribution to journalReview articleResearchpeer-review

10 Citations (Scopus)

Abstract

Purpose of review Several expanded criteria for liver transplantation for hepatocellular carcinoma (HCC) have been suggested out of concern that the Milan criteria may be too strict, and thereby exclude patients who could benefit from this surgical procedure. However, most expanded criteria were designed for deceased donor liver transplantation. Living donor liver transplantation (LDLT) differs from that of deceased donor liver transplantation primarily because LDLT liver grafts are not public resources. Recent findings In Asian countries, where HCC is endemic, LDLT is the main currently available treatment option for HCC. High-volume LDLT centers throughout Asia have adopted their own expanded selection criteria for LDLT for HCC with acceptable long-term results. Some centers utilize tumor markers as one of the criterion to help select suitable candidates. Indeed, such adjunctive biomarkers may have prognostic relevance for patients with HCC. The use of both biological and histomorphologic parameters may increase the number of transplantable patients. Summary The overall chance of survival, and recipient/donor preferences as well as the risk of recurrence are considered in the LDLT setting. Therefore, the selection criteria for liver transplantation for HCC could benefit from expansion for LDLT.

Original languageEnglish
Pages (from-to)231-237
Number of pages7
JournalCurrent Opinion in Organ Transplantation
Volume21
Issue number2
DOIs
StatePublished - 1 Apr 2016

Fingerprint

Living Donors
Liver Transplantation
Hepatocellular Carcinoma
Tissue Donors
Patient Selection
Tumor Biomarkers
Biomarkers
Transplants
Recurrence

Keywords

  • advanced hepatocellular carcinoma
  • biological markers
  • expected survival
  • living donor liver transplantation
  • patient selection

Cite this

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title = "Expansion of the criteria for living donor liver transplantation for hepatocellular carcinoma",
abstract = "Purpose of review Several expanded criteria for liver transplantation for hepatocellular carcinoma (HCC) have been suggested out of concern that the Milan criteria may be too strict, and thereby exclude patients who could benefit from this surgical procedure. However, most expanded criteria were designed for deceased donor liver transplantation. Living donor liver transplantation (LDLT) differs from that of deceased donor liver transplantation primarily because LDLT liver grafts are not public resources. Recent findings In Asian countries, where HCC is endemic, LDLT is the main currently available treatment option for HCC. High-volume LDLT centers throughout Asia have adopted their own expanded selection criteria for LDLT for HCC with acceptable long-term results. Some centers utilize tumor markers as one of the criterion to help select suitable candidates. Indeed, such adjunctive biomarkers may have prognostic relevance for patients with HCC. The use of both biological and histomorphologic parameters may increase the number of transplantable patients. Summary The overall chance of survival, and recipient/donor preferences as well as the risk of recurrence are considered in the LDLT setting. Therefore, the selection criteria for liver transplantation for HCC could benefit from expansion for LDLT.",
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Expansion of the criteria for living donor liver transplantation for hepatocellular carcinoma. / Lee, Hae Won; Suh, Kyungsuk.

In: Current Opinion in Organ Transplantation, Vol. 21, No. 2, 01.04.2016, p. 231-237.

Research output: Contribution to journalReview articleResearchpeer-review

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AU - Lee, Hae Won

AU - Suh, Kyungsuk

PY - 2016/4/1

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AB - Purpose of review Several expanded criteria for liver transplantation for hepatocellular carcinoma (HCC) have been suggested out of concern that the Milan criteria may be too strict, and thereby exclude patients who could benefit from this surgical procedure. However, most expanded criteria were designed for deceased donor liver transplantation. Living donor liver transplantation (LDLT) differs from that of deceased donor liver transplantation primarily because LDLT liver grafts are not public resources. Recent findings In Asian countries, where HCC is endemic, LDLT is the main currently available treatment option for HCC. High-volume LDLT centers throughout Asia have adopted their own expanded selection criteria for LDLT for HCC with acceptable long-term results. Some centers utilize tumor markers as one of the criterion to help select suitable candidates. Indeed, such adjunctive biomarkers may have prognostic relevance for patients with HCC. The use of both biological and histomorphologic parameters may increase the number of transplantable patients. Summary The overall chance of survival, and recipient/donor preferences as well as the risk of recurrence are considered in the LDLT setting. Therefore, the selection criteria for liver transplantation for HCC could benefit from expansion for LDLT.

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