Long-Term Outcomes of Living Donor Versus Deceased Donor Liver Transplant for Hepatocellular Carcinoma in the United States

Muhammad, Haris; Gürakar, Merve; Ting, Peng–Sheng; Alsughayer, Anas M; Luu, Harry; Zaffar, Duha; Alqahtani, Saleh A.; Bonder, Alan; Gürakar, Ahmet; Saberi, Behnam

doi:10.6002/ect.2021.0479

Cited by 5 publications

(4 citation statements)

References 23 publications

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“…Another study on a matched cohort comparison reported that LDLT had a higher overall rate of perioperative complications, mainly due to biliary complications, compared to DDLT, but 3-and 5-year graft and patient survivals were similar [68]. Multiple other studies also reported no significant differences in graft loss and patient survival in LDLT compared to DDLT [69,70]. However, another meta-analysis conducted in the United States reported a lower mortality at 1-, 3-, 5-years post-LT, a lower risk of rejection, but similar graft survival [71].…”

Section: Outcomes After Liver Transplantationmentioning

confidence: 99%

Approach to Liver Transplantation: Is There a Difference between East and West?

Ozturk,

Bartosek,

Toruner

et al. 2024

JCM

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Liver transplantation (LT) remains the only curative treatment for end-stage liver disease as well as acute liver failure. With the exponential increase in organ demand due to the increasing incidence and prevalence of liver diseases, the need to overcome the supply and demand mismatch has arisen. In this review, we discuss the current universal status of LT, emphasizing various LT practices worldwide.

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Section: Outcomes After Liver Transplantationmentioning

confidence: 99%

Approach to Liver Transplantation: Is There a Difference between East and West?

Ozturk,

Bartosek,

Toruner

et al. 2024

JCM

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“…The United States only utilizes LDLT in 1.5% of all LTs. However, LDLT is used more frequently in Asian countries and other countries with graft scarcity [86]. The model for end-stage liver disease (MELD) score predicts the survival of patients with advanced liver disease and its major use is the determination of the allocation of organs for liver transplants [87].…”

Section: Curative-intent Therapiesmentioning

confidence: 99%

Hepatocellular Carcinoma: Surveillance, Diagnosis, Evaluation and Management

Elderkin,

Al Hallak,

Azmi

et al. 2023

Cancers

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Hepatocellular carcinoma (HCC) ranks fourth in cancer-related deaths worldwide. Semiannual surveillance of the disease for patients with cirrhosis or hepatitis B virus allows for early detection with more favorable outcomes. The current underuse of surveillance programs demonstrates the need for intervention at both the patient and provider level. Mail outreach along with navigation provision has proven to increase surveillance follow-up in patients, while provider-targeted electronic medical record reminders and compliance reports have increased provider awareness of HCC surveillance. Imaging is the primary mode of diagnosis in HCC with The Liver Imaging Reporting and Data System (LI-RADS) being a widely accepted comprehensive system that standardizes the reporting and data collection for HCC. The management of HCC is complex and requires multidisciplinary team evaluation of each patient based on their preference, the state of the disease, and the available medical and surgical interventions. Staging systems are useful in determining the appropriate intervention for HCC. Early-stage HCC is best managed by curative treatment modalities, such as liver resection, transplant, or ablation. For intermediate stages of the disease, transarterial local regional therapies can be applied. Advanced stages of the disease are treated with systemic therapies, for which there have been recent advances with new drug combinations. Previously sorafenib was the mainstay systemic treatment, but the recent introduction of atezolizumab plus bevacizumab proves to have a greater impact on overall survival. Although there is a current lack of improved outcomes in Phase III trials, neoadjuvant therapies are a potential avenue for HCC management in the future.

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“…In countries with high LDLT rates, the selection of patients can be expanded to include a select group of patients outside of Milan or UCSF criteria (1,31). One advantage of LDLT in these conditions is that it does not affect the limited deceased donor pool and offers similar overall survival between DDLT and LDLT recipients (1,32,33). Approximately 25% of the patients with cirrhosis and HCC are removed from the waiting list with the progression of the diseases, and LDLT offers the advantage of LT to be performed in an elective setting hence optimizing the timing of the operation and reducing waiting time (2,12).…”

Section: Living-donor Liver Transplantation In Hepatocellular Carcinomamentioning

confidence: 99%

“…[ 1 , 31 ] One advantage of LDLT in these conditions is that it does not affect the limited deceased donor pool and offers similar overall survival between DDLT and LDLT recipients. [ 1 , 32 , 33 ] Approximately 25% of the patients with cirrhosis and HCC are removed from the waiting list with the progression of the diseases, and LDLT offers the advantage of LT to be performed in an elective setting, thereby optimizing the timing of the operation and reducing waiting time. [ 2 , 12 ] However, the risk of morbidity and mortality of the donor should be considered while expanding the criteria to maximize the LT and protect both donor and recipient.…”

Section: Living-donor Liver Transplantation In Hepatocellular Carcinomamentioning

confidence: 99%