Peritoneal Recurrence of Initially Controlled Hepatocellular Carcinoma after Living Donor Liver Transplantation

Садыков, Н К; Soyama, Akihiko; Hidaka, Masaaki; Kinoshita, Akio; Takatsuki, Mitsuhisa; Adachi, Tomohiko; Kitasato, Amane; Fujita, Fumihiko; Kuroki, Tamotsu; Eguchi, Susumu

doi:10.1159/000375117

Cited by 3 publications

(2 citation statements)

References 24 publications

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“…The patient received LDLT 11 months after the bridging period, while downstaging of HCC with three cycles of TACE and no recurrence was observed 20 months after the operation. Data and outcomes of previous studies on LT after HCC rupture and our present study results are described in Table 3 ( 13 – 15 , 20 ). The present study contributes significantly to the field compared to previous case reports because this study had multiple cases treated with a similar protocol at a single center and was limited to patients who received a liver from a living donor.…”

Section: Discussionmentioning

confidence: 92%

Outcomes of Living Donor Liver Transplantation in Patients With a History of Ruptured Hepatocellular Carcinoma

Lee

Hong

et al. 2021

Front. Surg.

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Background: Liver transplantation (LT) is considered a contraindication in patients with a history of hepatocellular carcinoma (HCC) rupture because ruptured HCCs are classified as T4 in the current American Joint Committee on Cancer TNM system. This study aimed to assess living donor liver transplantation (LDLT) in these patients and elucidate the factors that may have affected their outcomes.Methods: Data of patients with a history of ruptured HCC who underwent LDLT between January 1999 and December 2019 were retrospectively reviewed.Results: Among 789 patients who underwent LDLT for HCC, five (0.64%) had a history of HCC rupture. Three patients (60%) were treated with transarterial chemoembolization (TACE) or transarterial embolization (TAE) for hemostasis, and two patients (40%) achieved spontaneous hemostasis. One of two patients who achieved spontaneous hemostasis underwent surgical resection and LT at 1 week and 6 years after the rupture, respectively. The other patient underwent LT 2 days after the rupture. Four patients (80%) survived for >5 years, while two patients (40%) experienced recurrence and succumbed during the median follow-up duration of 85.3 months (range, 12.4–182.7). The recurrence first developed at 4.3 and 17.0 months after LT; these patients were managed well using surgical resection for peritoneal seeding and TACE for intrahepatic HCC.Conclusion: LDLT can be considered a treatment method even in patients with a history of HCC rupture after full evaluation of tumor biology and risk of recurrence.

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Section: Discussionmentioning

confidence: 92%

Outcomes of Living Donor Liver Transplantation in Patients With a History of Ruptured Hepatocellular Carcinoma

Lee

Hong

et al. 2021

Front. Surg.

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“…[3][4][5] Hepatocellular carcinoma recurrence after LDLT has long been recognized as a reason for high patient mortality. [6][7][8] In addition, the risk of HBV reinfection after LDLT can be minimized by efficient combinations of therapeutic prophylactic agents. [9][10][11][12][13] However, emergence of drug mutations, such as emergence of the HBV polymerase gene locus known as tyrosine-methionine-aspartate-aspartate (YMDD), can result in resistance to the commonly used HBV prophylactic agents, including the purine nucleoside analog reverse-transcriptase inhibitor lamivudine.…”

Section: Introductionmentioning

confidence: 99%

Untitled

Nafady-Hego

Elgendy

Nafady³

et al. 2016

Exp Clin Transplant

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Objectives: Despite living-donor liver transplant being a life-saving therapy for patients with hepatitis B virus with or without hepatocellular carcinoma, outcomes for patients with these diseases are worse. Hepatitis B virus recurrence or relapse of hepatocellular carcinoma can result in subsequent graft loss or patient death. In this study, we discuss the postoperative outcomes of patients with hepatitis B virus infection after living-donor liver transplant. Materials and Methods: We retrospectively analyzed 125 patients with hepatitis B virus-related end-stage liver disease, comparing results with 1228 control patients who had other pathologies, including hepatitis C virus, combined hepatitis B virus and hepatitis C virus, and neither virus. Results: Survival rates of patients with hepatitis B virus did not differ from the control groups (P > .05). Patients with concurrent hepatitis B virus and hepatocellular carcinoma were significantly older (P < .0001), had critical status (P < .0001), had chronic underlying pathology (P = .001), lower graft-torecipient body weight ratio (P = .047), needed more intraoperative plasma transfusion, and experienced more rejection episodes than those without hepatocellular carcinoma. Of interest, in 5 patients who had hepatitis B virus recurrence after living-donor liver transplant, Model for End-Stage Liver Disease score was significantly higher than those who did not have recurrence (P = .015). In addition, 2 patients had hepatocellular carcinoma recurrence in the form of peritoneal metastasis, with both patients having high preoperative alpha-fetoprotein levels. Conclusions: Our study provides details on long-term outcomes of patients with hepatitis B virus infection who had undergone living-donor liver transplant. Based on our results, we suggest that prolonged antiviral prophylactic therapy in the form of hepatitis B immunoglobulin with either lamivudine or entecavir be considered for patients who associated with risk factors to prevent postoperative recurrence.

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Expanding Indications for Liver Transplantation in the Treatment of Hepatocellular Carcinoma

Hogen,

Barry,

Subramanian

2024

Current Oncology

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Improvements in downstaging therapies have expanded the indications for liver transplantation (LT) for hepatocellular carcinoma (HCC). Patients with more advanced disease are now considered candidates due to advancements in radiation therapy, combination therapies, and immunotherapy. Combination stereotactic body radiation therapy (SBRT) and trans-arterial chemoembolization (TACE) has been shown to be superior to the historic treatment, sorafenib, in patients with macrovascular invasion. These patients are now candidates for LT with stable disease after LRT. Patients with ruptured HCC and prolonged stability have also been shown to have acceptable outcomes. The role of neoadjuvant immunotherapy needs to be further defined and has the potential to further improve tumor control prior to transplant.

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Peritoneal Recurrence of Initially Controlled Hepatocellular Carcinoma after Living Donor Liver Transplantation

Cited by 3 publications

References 24 publications

Outcomes of Living Donor Liver Transplantation in Patients With a History of Ruptured Hepatocellular Carcinoma

Outcomes of Living Donor Liver Transplantation in Patients With a History of Ruptured Hepatocellular Carcinoma

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Expanding Indications for Liver Transplantation in the Treatment of Hepatocellular Carcinoma

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