| Living donor liver transplantation for hepatocellular carcinoma: the impact of neo-adjuvant treatments on the long term results. | |
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MedLine Citation:
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PMID: 22353516 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Background/Aims: LDLT may represent a valid therapeutic option allowing several advantages for patients affected by HCC and waiting for liver transplantation (LT). However, some reports show a worse long term survival and disease free survival among patients treated by LDLT for HCC than deceased donor liver transplantation (DDLT) recipients. Methodology: Among 1145 LT patients, 63 received LDLT. From January 2000 to December 2008, 179 patients underwent LT due to HCC, 30 (16.7%) received LDLT and 154 (86.0%) received DDLT. Patients were selected based on the Milan criteria. TACE, radiofrequency ablation, percutaneous alcoholization, or liver resection were applied as downstaging procedures, while on the waiting list. Results: Overall 3- and 5-year survival rate was 77.3% and 68.7% vs. 82.8% and 76.7%, respectively for LDLT and DDLT recipient with not significant differences. Moreover, 3- and 5- years of recurrence free survival rate was 95.5% (LDLT) vs. 90.5% and 89.4% (DDLT) and resulted not significantly different. Conclusions: LDLT guarantees same long term results than DDLT if the selection criteria of candidates are analogues. Milan criteria remains a valid candidate selection tool to obtain optimal long term results in LDLT. An aggressive downstaging policy seems to improve the long-term results in LDLT, thus LRT may be considered useful to prevent tumor progression waiting for transplantation as well as a neoadjuvant therapy for HCC. A literature detailed meta-analysis could definitely clarify if LDLT is an independent risk factor for HCC recurrence. |
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Authors:
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Stefano Di Sandro; Alessandro Giacomoni; Abdallah Slim; Andrea Lauterio; Iacopo Mangoni; Plamen Mihaylov; Vincenzo Pirotta; Paolo Aseni; Luciano De Carlis |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Hepato-gastroenterology Volume: 59 ISSN: 0172-6390 ISO Abbreviation: Hepatogastroenterology Publication Date: 2012 Mar-Apr |
Date Detail:
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Created Date: 2012-02-22 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8007849 Medline TA: Hepatogastroenterology Country: Greece |
Other Details:
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Languages: eng Pagination: 505-10 Citation Subset: IM |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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