International Session(Symposium)1(JSH・JSGE・JSGCS)
Fri. November 3rd   14:30 - 17:00   Room 9: Portopia Hotel Main Building Kairaku 3
Nationwide survey of living donor liver transplantation outcomes for hepatocellular carcinoma
Masahiro Ohira1, Hideki Ohdan1
1Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University
The 5-5-500 criteria was proposed as an expanded criteria for liver transplantation (LT) for hepatocellular carcinoma (HCC), and together with the Milan criteria, it became an insurance indication for LT.
We conducted a nationwide survey of LDLT for HCC performed from 2010 to 2018, covering 516 cases at 37 centers nationwide. Analysis 1: Overall survival (OS) and recurrence-free survival (RFS) according to the new Japan criteria and the four-group classification of the Milan and 5-5-500 criteria were analyzed. Analysis 2: Cox proportional hazards model was used to analyze prognostic factors on RFS in 474 patients within the Japan criteria.
The 5-year OS and RFS for patients within and outside the Japan criteria were 81% vs. 58% and 77% vs. 48%, respectively. The 5-year OS and RFS for patients within the Milan criteria and outside the 5-5-500 criteria were 60% and 55%, respectively, worse than those for other patients within the criteria. Univariate analysis identified NLR 5 or higher, AFP 500 or higher, ALBI Grade 3, prior hepatectomy, and AFP-model 3 or higher as poor prognostic factors for patients within the criteria, while multivariate analysis identified NLR 5 or higher and prior hepatectomy as independent risk factors.
The results LDLT outcomes for HCC indicate that the Japan criteria are valid, but as in previous surveys, patients within the Milan criteria and outside the 5-5-500 criteria had poor outcomes.
Index Term 1: HCC
Index Term 2: Liver transplantation
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