2017
DOI: 10.21037/tgh.2017.10.01
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Perfusion machines and hepatocellular carcinoma: a good match between a marginal organ and an advanced disease?

Abstract: Hepatocellular carcinoma (HCC) accounts for 90% of primary liver cancers, is the second leading cause of cancer-related deaths and the leading cause of death in patients with cirrhosis. Liver transplantation (LT) represents the ideal treatment for selected patients as it removes both the tumor and the underlying cirrhotic liver with 5-year survival rates higher than 70%. Unfortunately, due to tumor characteristics, patient co-morbidities or shortage of organs available for transplant, only 20% of patients can … Show more

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Cited by 9 publications
(4 citation statements)
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“…9,100 Based on the known impact of the medical fitness of the candidate to overcome the reperfusion syndrome and the potential perioperative complications in the immediate posttransplant phase, the majority of DCD liver grafts are allocated to candidates listed with low laboratory MELD scores. 32,33,101 Although a few studies have assessed outcomes in recipients with HCC transplanted with DCD liver grafts, the data on the recurrence rate remain fairly limited and are reported with a range between 10% and 15%. 30,98,102 The recurrence rate generally depends on the tumor status (load, activity, vascular invasion) and the majority of studies included LT with candidates inside Milan or University of California San Francisco criteria.…”
Section: Recipient Underlying Diseasementioning
confidence: 99%
“…9,100 Based on the known impact of the medical fitness of the candidate to overcome the reperfusion syndrome and the potential perioperative complications in the immediate posttransplant phase, the majority of DCD liver grafts are allocated to candidates listed with low laboratory MELD scores. 32,33,101 Although a few studies have assessed outcomes in recipients with HCC transplanted with DCD liver grafts, the data on the recurrence rate remain fairly limited and are reported with a range between 10% and 15%. 30,98,102 The recurrence rate generally depends on the tumor status (load, activity, vascular invasion) and the majority of studies included LT with candidates inside Milan or University of California San Francisco criteria.…”
Section: Recipient Underlying Diseasementioning
confidence: 99%
“…Liver transplantation is an ideal treatment for selected patients with HCC, as it removes both the tumor and potential cirrhosis, with 5-year survival rate exceeding 70% [29]. However, due to tumor characteristics, patient co-morbidities or shortage of organs available for transplant, only 20% of patients can undergo curative treatment [30]. Locoregional therapies play an important role at all stages of HCC, aiming to increase overall survival while preserving liver function [31].…”
Section: Discussionmentioning
confidence: 99%
“…Such organs transmit a higher risk of impaired function and posttransplant complications and also include pre-injured donor livers donated after circulatory death (DCD) with prolonged warm ischaemia times in some countries. The instinctive high-risk donor to low medical-risk recipient combination may place these patients at increased risk of higher tumour recurrence and, potentially, compromised HCC transplant outcomes [8].…”
Section: Introductionmentioning
confidence: 99%