TY - JOUR
T1 - Recipient liver function before liver transplantation influences post-transplantation survival in patients with HCC
AU - Foerster, Friedrich
AU - Mittler, Jens
AU - Darstein, Felix
AU - Heise, Michael
AU - Marquardt, Jens U.
AU - Wörns, Marcus Alexander
AU - Weinmann, Arndt
AU - Sälter, Lina
AU - Hoppe-Lotichius, Maria
AU - Heinrich, Stefan
AU - Kloeckner, Roman
AU - Pitton, Michael B.
AU - Schattenberg, Jörn M.
AU - Sprinzl, Martin F.
AU - Düber, Christoph
AU - Otto, Gerd
AU - Lang, Hauke
AU - Galle, Peter R.
AU - Zimmermann, Tim
N1 - Publisher Copyright:
© 2018 European Federation of Internal Medicine
PY - 2018/9
Y1 - 2018/9
N2 - Background: Liver transplantation (LT) is a complex yet curative treatment for a subset of patients with hepatocellular carcinoma (HCC). Due to donor organ shortage, patients with HCC need to be carefully selected for LT. In European countries, selection of patients is based on the Milan criteria, and donor organs are allocated by Eurotransplant. In order to optimize the utilization of available liver grafts, the outcome of HCC patients after LT needs to be closely monitored and evaluated. Methods: We assessed the outcome of 304 HCC patients who underwent LT at a tertiary medical center over a period of nearly 20 years (February 1998 until June 2017). Results: The 5-, 10- and 15-year survival rates were 62, 47 and 30%, respectively. The strongest survival-determining factor was tumour recurrence. Apart from a high tumour grading, the pre-LT MELD score was significantly and negatively associated with survival after LT. Conclusion: Our results confirm the importance of recurrence for the outcome of HCC patients after LT and highlight the relevance of HCC patients’ liver function before LT. Our findings encourage efforts to identify prognostically relevant factors for LT in HCC with the overall goal of refining the organ allocation system and maximizing the survival benefit after LT.
AB - Background: Liver transplantation (LT) is a complex yet curative treatment for a subset of patients with hepatocellular carcinoma (HCC). Due to donor organ shortage, patients with HCC need to be carefully selected for LT. In European countries, selection of patients is based on the Milan criteria, and donor organs are allocated by Eurotransplant. In order to optimize the utilization of available liver grafts, the outcome of HCC patients after LT needs to be closely monitored and evaluated. Methods: We assessed the outcome of 304 HCC patients who underwent LT at a tertiary medical center over a period of nearly 20 years (February 1998 until June 2017). Results: The 5-, 10- and 15-year survival rates were 62, 47 and 30%, respectively. The strongest survival-determining factor was tumour recurrence. Apart from a high tumour grading, the pre-LT MELD score was significantly and negatively associated with survival after LT. Conclusion: Our results confirm the importance of recurrence for the outcome of HCC patients after LT and highlight the relevance of HCC patients’ liver function before LT. Our findings encourage efforts to identify prognostically relevant factors for LT in HCC with the overall goal of refining the organ allocation system and maximizing the survival benefit after LT.
UR - http://www.scopus.com/inward/record.url?scp=85047602419&partnerID=8YFLogxK
U2 - 10.1016/j.ejim.2018.05.024
DO - 10.1016/j.ejim.2018.05.024
M3 - Journal articles
C2 - 29859798
AN - SCOPUS:85047602419
SN - 0953-6205
VL - 55
SP - 57
EP - 65
JO - European Journal of Internal Medicine
JF - European Journal of Internal Medicine
ER -
