Living-donor liver transplantation associated with higher incidence of hepatocellular carcinoma recurrence than deceased-donor liver transplantation

Min Su Park, Kwang Woong Lee, Suk Won Suh, Tae You, Youngrok Choi, Hyeyoung Kim, Geun Hong, Nam Joon Yi, Choon Hyuck David Kwon, Jae Won Joh, Suk Koo Lee, Kyung Suk Suh

Research output: Contribution to journalArticlepeer-review

49 Scopus citations

Abstract

Background: Living-donor liver transplantation (LDLT) is becoming an important tool in hepatocellular carcinoma (HCC) treatment. However, the oncologic outcome between LDLT and deceased-donor LT (DDLT) for HCC remains controversial. This study aims to compare the HCC recurrence rates after LDLT versus DDLT. Methods: Two hundred sixteen patients (166 LDLTs and 50 DDLTs) who underwent LT for HCC within University of California-San Francisco criteria were retrospectively reviewed. LDLT patients were divided into two groups: small living-donor graft (LDG; graft-to-recipient body weight ratio<1.0, n=59) and nonsmall LDG (graft-to-recipient body weight ratio≥1.0, n=107). Patients were further stratified into low-and high-risk settings by the number of risk factors for recurrence. Results: The recurrence-free survival was lower in LDLT compared with DDLT (88.6% and 80.7% vs. 96.0% and 94.0% at 1 and 5 years; P=0.045). There was no significant difference between two groups regarding the majority of clinical and tumor characteristics, with the exception of a higher proportion of microvascular invasion presence in LDLT. After the adjustment for microvascular invasion, LDLT was identified as an independent risk factor for recurrence. Moreover, recurrence-free survival between small and nonsmall LDG was not statistically significant. In low-risk setting (≤1 risk factor), LDLT showed comparable outcome with DDLT. However, the risk of recurrence was higher in LDLT than DDLT in high-risk patients. CONCLUSION: In conclusion, LDLT showed poorer outcome than DDLT. This should be considered to select optimal strategy for HCC.

Original languageEnglish
Pages (from-to)71-77
Number of pages7
JournalTransplantation
Volume97
Issue number1
DOIs
StatePublished - 15 Jan 2014

Keywords

  • Deceased-donor liver transplantation
  • Hepatocellular carcinoma
  • Living-donor liver transplantation
  • Recurrence

Fingerprint

Dive into the research topics of 'Living-donor liver transplantation associated with higher incidence of hepatocellular carcinoma recurrence than deceased-donor liver transplantation'. Together they form a unique fingerprint.

Cite this