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dc.contributor.author | Llovet i Bayer, Josep Maria |
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dc.contributor.author | Pavel, Mihai |
dc.contributor.author | Rimola, Jordi |
dc.contributor.author | Diaz, Maria Alba |
dc.contributor.author | Colmenero, Jordi |
dc.contributor.author | Saavedra, David |
dc.contributor.author | Fondevila Campo, Constantino |
dc.contributor.author | Ayuso Colella, Carmen |
dc.contributor.author | Fuster Obregón, Josep |
dc.contributor.author | Ginès i Gibert, Pere |
dc.contributor.author | Bruix Tudó, Jordi |
dc.contributor.author | García-Valdecasas Salgado, Juan Carlos |
dc.date | 2018-01-12T18:55:05Z |
dc.date | 2018-11-15T06:10:23Z |
dc.date | 2017-11-15 |
dc.date | 2018-01-12T18:55:05Z |
dc.identifier | 1527-6465 |
dc.identifier | 675304 |
dc.identifier | 29140601 |
dc.identifier.uri | http://hdl.handle.net/2445/119018 |
dc.description | BACKGROUND & AIMS: A subset of patients with hepatocellular carcinoma (HCC) beyond Milan criteria might obtain acceptable survival outcomes after liver transplantation. Living donor liver transplantation (LDLT) has emerged as a feasible alternative to overcome the paucity of donors. METHODS: In 2001 we started a protocol for LDLT in Child A-B patients with HCC fulfilling a set of criteria - the BCLC expanded criteria- that expanded the conventional indications of transplantation: 1 tumor ≤ 7cm, 5 tumors ≤ 3cm, 3 tumors ≤ 5cm without macrovascular invasion or down-staging to Milan after loco-regional therapies. RESULTS: We present a prospective cohort of 22 patients with BCLC extended indications based on size/number (17) or down-staging (5) treated with LDLT between 2001 and 2014. Characteristics of the patients were as follows: median age: 57yr old; males/female: 20/2, Child-Pugh A/B: 16/6, AFP <100ng/mL: 21. Twelve patients received neo-adjuvant loco-regional therapies. At the time of transplantation, 12 patients had HCC staging beyond Milan criteria and 10 within. Pathological reports showed that 50% exceeded BCLC expanded criteria. Perioperative mortality was 0%. After a median follow up of 81 months, the 1-, 3-, 5- and 10-year survival was 95.5%, 86.4%, 80.2% and 66.8%, respectively. Overall, seven patients recurred (range 9-108 mo), and the 5-y and 10-yr actuarial recurrence rate was of 23.8% and 44,4%, respectively. CONCLUSION: A proper selection of candidates for extended indications of living donor liver transplantation for HCC patients provide survival outcomes comparable t |
dc.format | 35 p. |
dc.format | application/pdf |
dc.language | eng |
dc.publisher | No longer published by Elsevier |
dc.relation | Versió postprint del document publicat a: https://doi.org/10.1002/lt.24977 |
dc.relation | Liver Transplantation, 2017 |
dc.relation | https://doi.org/10.1002/lt.24977 |
dc.rights | (c) American Association for the Study of Liver Diseases, 2017 |
dc.rights | info:eu-repo/semantics/openAccess |
dc.subject | Trasplantament hepàtic |
dc.subject | Pronòstic mèdic |
dc.subject | Càncer de fetge |
dc.subject | Hepatic transplantation |
dc.subject | Prognosis |
dc.subject | Liver cancer |
dc.title | Pilot study of living donor liver transplantation for patients with HCC exceeding Milan criteria |
dc.type | info:eu-repo/semantics/article |
dc.type | info:eu-repo/semantics/acceptedVersion |