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Journal of Gastrointestinal Cancer

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01-12-2021 | Liver Transplantation | Invited Reviews

Prognostic Factors of Liver Transplantation for HCC: Comparative Literature Review

Authors: Altan Alim, Cihan Karataş

Published in: Journal of Gastrointestinal Cancer | Issue 4/2021

Abstract

Purpose

The aim of the review study is investigation of the prognostic factors of the liver transplantation for hepatocellular carcinoma.

Methods

A literature review has been made, especially in countries where dominantly living donor liver transplantation is performed, such as Turkey. Liver transplantation from deceased donor and from living donor has been evaluated about as advantages and disadvantages, and their effects on prognosis have been compared. In addition, hepatocellular carcinoma series of Koç University Liver Transplantation center has been presented.

Results

Liver transplantation is still the best treatment option with 5-year 50% survival rate for hepatocellular carcinoma even in patient who has locally advanced tumor. The patient’s survival is not only an important issue but also the living donor’s safety is controversial particularly when expectation of recipient’s 5-year survival is below 50% due to donor complication.

Conclusion

Detailed preoperative examination, appropriate patient selection, and timing of surgery are seen the most important issues in liver transplant’s patients with hepatocellular carcinoma.

World cancerreport.http://publications.iarc.fr/NonSeriesPublications/World-Cancer-Reports/World-Cancer-R

Desai A, Sandhu S, Lai JP, Sandhu DS. Hepatocellular carcinoma in non-cirrhotic liver: a comprehensive review. World J Hepatol. 2019;11(1):1–18. https://doi.org/10.4254/wjh.v11.i1.1.PMID:30705715;PMCID:PMC6354117.CrossRefPubMedPubMedCentral

Alim A, Erdogan Y, Dayangac M, Yuzer Y, Tokat Y, Oezcelik A. Living donor liver transplantation: the optimal curative treatment for hepatocellular carcinoma even beyond Milan criteria. Cancer Control. 2021;28:10732748211011960. https://doi.org/10.1177/10732748211011960.PMID:33926242;PMCID:PMC8204628.CrossRefPubMedPubMedCentral

Ince V, Akbulut S, Otan E, Ersan V, Karakas S, Sahin TT, Carr BI, Baskiran A, Samdanci E, Bag HG, Koc C, Usta S, Ozdemir F, Barut B, Gonultas F, Sarici B, Kutluturk K, Dogan MS, Ozgor D, Dikilitas M, Harputluoglu M, Aladag M, Kutlu R, Varol I, Dirican A, Aydin C, Isik B, Ara C, Kayaalp C, Emre S, Yilmaz S. Liver transplantation for hepatocellular carcinoma: Malatya experience and proposals for expanded criteria. J Gastrointest Cancer. 2020;51(3):998–1005. https://doi.org/10.1007/s12029-020-00424-w.Erratum.In:JGastrointestCancer.2020Jul8; (PMID: 32519232).CrossRefPubMed

Takamatsu FY, Gonzalez AM, Sá GP, Salzedas-Netto AA. Transplantation in hepatocellular carcinoma: observational multivariate analysis of survival and recurrence factors in 414 patients. Transplant Proc. 2021:S0041–1345(21)00407–3. https://doi.org/10.1016/j.transproceed.2021.06.002. Epub ahead of print. PMID: 34229903.

Yankol Y, HoŞ G, Kanmaz T, Mecİt N, ÇakaloĞlu Y, KalayoĞlu M, Acarli KS. Are the criteria always right? Assessment of hepatocellular carcinoma cases in living donor liver transplantation at a high-volume center. Turk J Med Sci. 2021. https://doi.org/10.3906/sag-2101-51. Epub ahead of print. PMID: 33754656.

Alim A, Malamutmann E, Dayangac M, Erdogan Y, Gokakin AK, Tokat Y, Oezcelik A. Comorbidity index as a selection tool for living donor liver transplantation in elderly patients. Transplant Proc. 2019;51(10):3315–9. https://doi.org/10.1016/j.transproceed.2019.07.030 (Epub 2019 Nov 14 PMID: 31735323).CrossRefPubMed

Mazzaferro V, Regalia E, Doci R, Andreola S, Pulvirenti A, Bozzetti F, et al. Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med. 1996;334:693–9.CrossRefPubMed

Yao FY, Ferrell L, Bass NM, Watson JJ, Bacchetti P, Venook A, et al. Liver transplantation for hepatocellular carcinoma: expansion of the tumor size limits does not adversely impact survival. Hepatology. 2001;33(6):1394–403.CrossRefPubMed

10.

Bruix J, Llovet JM. Prognostic prediction and treatment strategy in hepatocellular carcinoma. Hepatology. 2002;35(3):519–24. https://doi.org/10.1053/jhep.2002.32089.

11.

Ito T, Takada Y, Ueda M, Haga H, Maetani Y, Oike F, et al. Expansion of selection criteria for patients with hepatocellular carcinoma in living donor liver transplantation. Liver Transpl. 2007;13:1637–44.CrossRefPubMed

12.

Sugawara Y, Tamura S, Makuuchi M. Living donor liver transplantation for hepatocellular carcinoma: Tokyo University series. Dig Dis. 2007;25(4):310–2.CrossRefPubMed

13.

Jonas S, Mittler J, Pascher A, Schumacher G, Theruvath T, Benckert C, et al. Living donor liver transplantation of the right lobe for hepatocellular carcinoma in cirrhosis in a European center. Liver Transpl. 2007;13(6):896–903.CrossRefPubMed

14.

Lee SG, Hwang S, Moon DB, Ahn CS, Kim KH, Sung KB, et al. Expanded indication criteria of living donor liver transplantation for hepatocellular carcinoma at one large-volume center. Liver Transpl. 2008;14(7):935–45.CrossRefPubMed

15.

Zheng SS, Xu X, Wu J, Chen J, Wang WL, Zhang M, et al. Liver transplantation for hepatocellular carcinoma: Hangzhou experiences. Transplantation. 2008;85(12):1726–32.CrossRefPubMed

16.

Mazzaferro V, Llovet JM, Miceli R, Bhoori S, Schiavo M, Mariani L, et al. Predicting survival after liver transplantation in patients with hepatocellular carcinoma beyond the Milan criteria: a retrospective, exploratory analysis. Lancet Oncol. 2009;10(1):35–43.CrossRefPubMed

17.

Duvoux C, Roudot-Thoraval F, Decaens T, et al. Liver transplantation for hepatocellular carcinoma: a model including αfetoprotein improves the performance of Milan criteria. Gastroenterology. 2012;143:986–94.CrossRefPubMed

18.

Sapisochin G, Goldaracena N, Laurence JM, Dib M, Barbas A, Ghanekar A, et al. The extended Toronto criteria for liver transplantation in patients with hepatocellular carcinoma: a prospective validation study. Hepatology. 2016;64(6):2077–88.CrossRefPubMed

19.

Eggel H. Ueber das primare Carcinom der Leber (in German). Beitz Path01 Anat 1901; 30: 506–604.

20.

Kojiro M. Histopathology of liver cancers. Best Pract Res Clin Gastroenterol. 2005;19(1):39–62. https://doi.org/10.1016/j.bpg.2004.10.007. PMID:15757804CrossRefPubMed

21.

Clayton EF, Malik S, Bonnel A, Mu Y, Olthoff K, Shaked A, Abt PL, Peterman H, Rajender Reddy K, Ottmann S, Furth EE, Levine MH. Liver transplantation and cirrhotomimetic hepatocellular carcinoma: classification and outcomes. Liver Transpl. 2014;20(7):765–74. https://doi.org/10.1002/lt.23876. Epub 2014 May 26. PMID: 24668931; PMCID: PMC4146426

22.

Reynolds AR, Furlan A, Fetzer DT, Sasatomi E, Borhani AA, Heller MT, Tublin ME. Infiltrative hepatocellular carcinoma: what radiologists need to know. Radiographics. 2015;35(2):371–86. https://doi.org/10.1148/rg.352140114 (PMID: 25763723).CrossRefPubMed

23.

Esnaola NF, Lauwers GY, Mirza NQ, et al. Predictors of microvascular invasion in patients with hepatocellular carcinoma who are candidates for orthotopic liver transplantation. J Gastrointest Surg. 2002;6:224.CrossRefPubMed

24.

Carr BI, Akkiz H, Üsküdar O, Yalçın K, Guerra V, Kuran S, Karaoğullarından Ü, Altıntaş E, Özakyol A, Tokmak S, Ballı T, Yücesoy M, Bahçeci Hİ, Ülkü A, Akçam T, Polat KY, Ekinci N, Şimşek H, Örmeci N, Sonsuz A, Demir M, Kılıç M, Uygun A, Demir A, Delik A, Arslan B, Doran F, Yilmaz S, Tokat Y. HCC with low- and normal-serum alpha-fetoprotein levels. Clin Pract (Lond). 2018;15(1):453–64. https://doi.org/10.4172/clinical-practice.1000393.PMID:29576865;PMCID:PMC5865641.CrossRef

25.

Si YQ, Wang XQ, Fan G, Wang CY, Zheng YW, Song X, Pan CC, Chu FL, Liu ZF, Lu BR, Lu ZM. Value of AFP and PIVKA-II in diagnosis of HBV-related hepatocellular carcinoma and prediction of vascular invasion and tumor differentiation. Infect Agent Cancer. 2020;15(1):70. https://doi.org/10.1186/s13027-020-00337-0.PMID:33292429;PMCID:PMC7684907.CrossRefPubMedPubMedCentral

26.

Ince V, Ara C, Yilmaz S. Malatya and other criteria for liver transplantation in hepatocellular carcinoma. J Gastrointest Cancer. 2020;51(4):1118–21. https://doi.org/10.1007/s12029-020-00484-y (PMID: 32860615).CrossRefPubMed

27.

Mähringer-Kunz A, Meyer FI, Hahn F, Müller L, Düber C, Pinto Dos Santos D, Galle PR, Weinmann A, Kloeckner R, Schotten S. Hepatic vein tumor thrombosis in patients with hepatocellular carcinoma: prevalence and clinical significance. United European Gastroenterol J. 2021;9(5):590–597. https://doi.org/10.1002/ueg2.12098. Epub 2021 Jun 2. PMID: 34077613; PMCID: PMC8259264

28.

Heimbach JK, Kulik LM, Finn RS, Sirlin CB, Abecassis MM, Roberts LR, Zhu AX, Murad MH, Marrero JA. AASLD guidelines for the treatment of hepatocellular carcinoma. Hepatology. 2018;67(1):358–80. https://doi.org/10.1002/hep.29086 (PMID: 28130846).CrossRefPubMed

29.

Association for the Study of the Liver, European Organisation for Research and Treatment of Cancer. Association for the Study of the Liver, European Organisation for Research and Treatment of Cancer. EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma. J Hepatol 2012; 56: 908

30.

Iwatsuki S, Dvorchik I, Marsh JW, et al. Liver transplantation for hepatocellular carcinoma: a proposal of a prognostic scoring system. J Am Coll Surg. 2000;191:389.CrossRefPubMedPubMedCentral

31.

Lee KW, Suh SW, Choi Y, Jeong J, Yi NJ, Kim H, Yoon KC, Hong SK, Kim HS, Lee KB, Suh KS. Macrovascular invasion is not an absolute contraindication for living donor liver transplantation. Liver Transpl. 2017;23(1):19–27. https://doi.org/10.1002/lt.24610 (Epub 2016 Dec 5 PMID: 27540701).CrossRefPubMed

32.

Jeong Y, Shin MH, Yoon SM, Song GW, Kim KH, Ahn CS, Moon DB, Hwang S, Park JH, Kim JH, Lee SG. Liver transplantation after transarterial chemoembolization and radiotherapy for hepatocellular carcinoma with vascular invasion. J Gastrointest Surg. 2017;21(2):275–83. https://doi.org/10.1007/s11605-016-3302-0 (Epub 2016 Oct 24 PMID: 27778254).CrossRefPubMed

33.

Aydin C, Yilmaz S. Is macroscopic portal vein tumor thrombosis of HCC really an exclusion for liver transplantation? J Gastrointest Cancer. 2020;51(4):1137–40. https://doi.org/10.1007/s12029-020-00488-8 (PMID: 32833219).CrossRefPubMed

34.

Assalino M, Terraz S, Grat M, Lai Q, Vachharajani N, Gringeri E, Bongini MA, Kulik L, Tabrizian P, Agopian V, Mehta N, Brustia R, Vitali GC, Andres A, Berney T, Mazzaferro V, Compagnon P, Majno P, Cillo U, Chapman W, Zieniewicz K, Scatton O, Toso C. Liver transplantation for hepatocellular carcinoma after successful treatment of macrovascular invasion - a multi-center retrospective cohort study. Transpl Int. 2020;33(5):567–75. https://doi.org/10.1111/tri.13586 (Epub 2020 Feb 20 PMID: 31994238).CrossRefPubMed

35.

Allen RA, Lisa JR. Combined liver cell and bile duct carcinoma. Am J Pathol. 1949 Jul;25(4):647–55. PMID: 18152860; PMCID: PMC1942823.

36.

Liver Cancer Study Group of Japan. The general rules for the clinical and pathological study of primary liver cancer. JAPANESE JOURNAL or SURGERY. 1989;19(1):98–129.CrossRef

37.

Jung DH, Hwang S, Song GW, Ahn CS, Moon DB, Kim KH, Ha TY, Park GC, Hong SM, Kim WJ, Kang WH, Kim SH, Yu ES, Lee SG. Longterm prognosis of combined hepatocellular carcinoma-cholangiocarcinoma following liver transplantation and resection. Liver Transpl. 2017;23(3):330–41. https://doi.org/10.1002/lt.24711 (PMID: 28027599).CrossRefPubMed

38.

Bergquist JR, Groeschl RT, Ivanics T, Shubert CR, Habermann EB, Kendrick ML, Farnell MB, Nagorney DM, Truty MJ, Smoot RL. Mixed hepatocellular and cholangiocarcinoma: a rare tumor with a mix of parent phenotypic characteristics. HPB (Oxford). 2016;18(11):886–892. https://doi.org/10.1016/j.hpb.2016.07.006. Epub 2016 Aug 18. PMID: 27546172; PMCID: PMC5094489.

39.

Gupta R, Togashi J, Akamatsu N, Sakamoto Y, Kokudo N. Impact of incidental/misdiagnosed intrahepatic cholangiocarcinoma and combined hepatocellular cholangiocarcinoma on the outcomes of liver transplantation: an institutional case series and literature review. Surg Today. 2017;47(8):908–17. https://doi.org/10.1007/s00595-017-1472-3 (Epub 2017 Jan 25 PMID: 28124125).CrossRefPubMed

40.

Lo CM, Fan ST, Liu CL, Chan SC, Ng IO, Wong J. Living donor versus deceased donor liver transplantation for early irresectable hepatocellular carcinoma. Br J Surg. 2007;94(1):78–86. https://doi.org/10.1002/bjs.5528 (PMID: 17016793).CrossRefPubMed

41.

Fisher RA, Kulik LM, Freise CE, Lok AS, Shearon TH, Brown RS Jr, Ghobrial RM, Fair JH, Olthoff KM, Kam I, Berg CL; A2ALL Study Group. Hepatocellular carcinoma recurrence and death following living and deceased donor liver transplantation. Am J Transplant. 2007;7(6):1601–8. https://doi.org/10.1111/j.1600-6143.2007.01802.x. PMID: 17511683; PMCID: PMC3176596.

42.

Sandhu L, Sandroussi C, Guba M, Selzner M, Ghanekar A, Cattral MS, McGilvray ID, Levy G, Greig PD, Renner EL, Grant DR. Living donor liver transplantation versus deceased donor liver transplantation for hepatocellular carcinoma: comparable survival and recurrence. Liver Transpl. 2012;18(3):315–22. https://doi.org/10.1002/lt.22477 (PMID: 22140013).CrossRefPubMed

43.

Wedd JP, Nordstrom E, Nydam T, Durham J, Zimmerman M, Johnson T, Thomas Purcell W, Biggins SW. Hepatocellular carcinoma in patients listed for liver transplantation: current and future allocation policy and management strategies for the individual patient. Liver Transpl. 2015;21(12):1543–52. https://doi.org/10.1002/lt.24356 (PMID: 26457885).CrossRefPubMed

44.

Yao FY, Bass NM, Nikolai B, Merriman R, Davern TJ, Kerlan R, Ascher NL, Roberts JP. A follow-up analysis of the pattern and predictors of dropout from the waiting list for liver transplantation in patients with hepatocellular carcinoma: implications for the current organ allocation policy. Liver Transpl. 2003;9(7):684–92. https://doi.org/10.1053/jlts.2003.50147 (PMID: 12827553).CrossRefPubMed

45.

Guler N, Yaprak O, Gunay Y, Dayangac M, Akyildiz M, Yuzer F, Yuzer Y, Tokat Y. Major complications of adult right lobe living liver donors. Hepatobiliary Pancreat Dis Int. 2015;14(2):150–6. https://doi.org/10.1016/s1499-3872(15)60346-0 (PMID: 25865687).CrossRefPubMed

46.

Yankol Y, Mecit N, Kanmaz T, Kalayoğlu M, Acarlı K. Complications and outcomes of 890 living liver donor hepatectomies at a single center: risks of saving loved one’s life. Turk J Surg. 2020;36(2):192–201. https://doi.org/10.5578/turkjsurg.4548.PMID:33015564;PMCID:PMC7515646.CrossRefPubMedPubMedCentral

47.

Patel S, Orloff M, Tsoulfas G, Kashyap R, Jain A, Bozorgzadeh A, Abt P. Living-donor liver transplantation in the United States: identifying donors at risk for perioperative complications. Am J Transplant. 2007;7(10):2344–9. https://doi.org/10.1111/j.1600-6143.2007.01938.x (PMID: 17845568).CrossRefPubMed

48.

Middleton PF, Duffield M, Lynch SV, Padbury RT, House T, Stanton P, Verran D, Maddern G. Living donor liver transplantation–adult donor outcomes: a systematic review. Liver Transpl. 2006;12(1):24–30. https://doi.org/10.1002/lt.20663 (PMID: 16498709).CrossRefPubMed

49.

Mehta N, Bhangui P, Yao FY, Mazzaferro V, Toso C, Akamatsu N, Durand F, Ijzermans J, Polak W, Zheng S, Roberts JP, Sapisochin G, Hibi T, Kwan NM, Ghobrial M, Soin A. Liver transplantation for hepatocellular carcinoma. Working Group Report from the ILTS Transplant Oncology Consensus Conference. Transplantation. 2020;104(6):1136–1142. https://doi.org/10.1097/TP.0000000000003174. PMID: 32217938.

Title: Prognostic Factors of Liver Transplantation for HCC: Comparative Literature Review
Authors: Altan Alim
Cihan Karataş
Publication date: 01-12-2021
Publisher: Springer US
Keywords: Liver Transplantation
Liver Transplantation
Hepatocellular Carcinoma
Liver Transplantation
Hepatocellular Carcinoma
Liver Transplantation
Liver Transplantation
Published in: Journal of Gastrointestinal Cancer / Issue 4/2021
Print ISSN: 1941-6628
Electronic ISSN: 1941-6636
DOI: https://doi.org/10.1007/s12029-021-00730-x

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