30 March 2015 : Original article
The Effect of Graft Type on Mortality in Liver Transplantation for Hepatocellular Carcinoma
Ryan P. CauleyABCDEFG, Kristina PotanosABDEF, Nora FullingtonABDEF, James GrijalvaCDEF, Dionne A. GrahamABCDE, Heung Bae KimACDEF, Khashayar VakiliABCDEFGDOI: 10.12659/AOT.892613
Ann Transplant 2015; 20:175-185
Abstract
BACKGROUND: Liver transplantation (LT) with living-donor (LD-P) and deceased-donor (DD-P) partial grafts for hepatocellular carcinoma (HCC) may be associated with worse outcomes. Using the United Network for Organ Sharing (UNOS), we aimed to: (1) examine the risk of mortality in LT for HCC, (2) to establish if this risk is affected by partial graft use, and (3) to determine if this effect is mitigated by improved tumor-associated risk stratification.
MATERIAL AND METHODS: All first-time adult LT recipients were analyzed (3/2002-12/2012), including 2,353 LD-P, 727 DD-P, and 47,833 DD whole (DD-W) grafts. Cox proportional hazards models were used to examine the risk of mortality given HCC. Interaction/subset analyses were used to examine the effect of tumor-risk and graft-type on outcome. Presence of an HCC exception and low alpha-fetoprotein (AFP) level (<66 ng/mL) were considered favorable.
RESULTS: Overall, HCC was associated with an increased mortality risk compared to the absence of HCC (HR 1.21 [1.15–1.27]), and the use of partial grafts was noted to further intensify this risk. However, HCC with a favorable risk profile had more comparable outcomes to patients without HCC and this finding was similar across all graft-types (Given LD-P: HR 1.14 [0.76–1.73]; Given DD-P: HR1.05 [0.71–1.56]; Given DD-W: HR1.08 [1.02–1.14]). On subset analysis, all graft types had similar outcomes given either favorable-risk HCC or the absence of HCC.
CONCLUSIONS: There is no significant difference in outcomes between whole and partial grafts given (1) patients with HCC with a favorable risk-profile or (2) patients without HCC.
Keywords: Liver Transplantation, Living Donors, Resource Allocation
In Press
04 Aug 2022 : Original article
Long-Term Patency of All-in-One Sleeve Patch Graft Venoplasty in 16 Patients Who Underwent Living Donor Liv...Ann Transplant In Press; DOI: 10.12659/AOT.936888
22 Jul 2022 : Original article
Diagnostic Role of Tumor Markers for Hepatocellular Carcinoma in Liver Transplantation Candidates: An Analy...Ann Transplant In Press; DOI: 10.12659/AOT.936937
22 Jul 2022 : Original article
Development of a Novel Model for Predicting Postoperative Short-Term Outcome in Patients with Hepatitis B-R...Ann Transplant In Press; DOI: 10.12659/AOT.936732
22 Jul 2022 : Original article
Leucine-Rich Alpha-2-Glycoprotein (LRG-1) as a Potential Kidney Injury Marker in Kidney Transplant RecipientsAnn Transplant In Press; DOI: 10.12659/AOT.936751
Most Viewed Current Articles
26 Jan 2022 : Review article
Recurrence of Hepatocellular Carcinoma After Liver Transplantation: Risk Factors and Predictive ModelsDOI :10.12659/AOT.934924
Ann Transplant 2022; 27:e934924
29 Dec 2021 : Original article
Efficacy and Safety of Tacrolimus-Based Maintenance Regimens in De Novo Kidney Transplant Recipients: A Sys...DOI :10.12659/AOT.933588
Ann Transplant 2021; 26:e933588
24 Jul 2020 : Review article
Kidney Transplantation in the Times of COVID-19 – A Literature ReviewDOI :10.12659/AOT.925755
Ann Transplant 2020; 25:e925755
15 Mar 2022 : Case report
Combined Liver, Pancreas-Duodenum, and Kidney Transplantation for Patients with Hepatitis B Cirrhosis, Urem...DOI :10.12659/AOT.935860
Ann Transplant 2022; 27:e935860