ASO Author Reflections: Liver Transplantation for Hepatocellular Carcinoma

Excerpt

It is controversial if living donor liver transplantation (LDLT) and deceased donor liver transplantation (DDLT) offer similar outcomes for hepatocellular carcinoma (HCC). Studies that compared the outcomes of LDLT and DDLT for HCC drew contradictory conclusions. LDLT and DDLT are different in terms of graft availability, allocation, waiting time, need for bridging therapy, risk of dropout, surgical technique, and graft size. The potential concerns of LDLT for HCC include a fast tracking effect and the possibility of higher tumor recurrence after transplant.1 The caveat is that survival data were evaluated from the time of transplant rather than from the time of listing, therefore the effect of waiting time and dropout was not considered. Another key issue is that LDLT patients tend to have more advanced tumor stage and have more salvage transplant. There were two reports from the French centers that evaluated outcomes of HCC patients from the time of listing but did not demonstrate any survival difference.2,3 …