International Session(Symposium)1(JSH・JSGE・JSGCS)
Fri. November 3rd   14:30 - 17:00   Room 9: Portopia Hotel Main Building Kairaku 3
Toward expanding indication of liver transplantation for hepatocellular carcinoma
Atsuyoshi Mita1, Yuji Soejima1
1Department of Surgery, Shinshu University School of Medicine
Background Hepatocellular carcinoma (HCC) within the Japan Criteria (JC) with Child-Pugh grade C liver cirrhosis is considered an indication for liver transplantation (LT). JC was born in 2019 as an expanding indication that combined the 5-5-500 criteria with the Milan criteria (MC). This study aimed to investigate the possibility of further indication expansion.
Method We retrospectively investigated cases in which LT was planned and performed at our hospital by February 2023. First, we evaluated the outcomes of deceased donor liver transplant (DDLT) candidates. Next, we examined outcome in adult recipients who underwent LT for HCC.
Result Of the 195 DDLT candidates on the list, 27 (13.8%) had HCC at the time of registration. Outcomes included DDLT in 6, switch to LDLT in 4, waiting death in 9, withdrawal in 5, still waiting in 3. All 5 withdrawals were due to progression of HCC. Forty-nine adult recipients who underwent LT for HCC included 39 within MC, 3 beyond MC within 5-5-500, and 7 within 5-5-500. The 5-year patient overall survival rates were 79.8, 66.7, 71.4%, and HCC recurrence rates within 5 years was 9.9, 50.0, 28.6%, respectively, showing no significant difference. (p=0.0553, p=0.2658). Age >56 years at LT was an independent risk factor for mortality after LT for HCC cases (p=0.0297).
Conclusion Early registration from Child-Pugh B should be considered to reduce waiting death for DDLT, especially for young patients.
Index Term 1: Hepatocellular carcinoma
Index Term 2: Child-Pugh score
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