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Liver transplantation for hepatocellular carcinoma

Mazzaferro, V and Chun, YS and Poon, RTP and Schwartz, ME and Yao, FY and Marsh, JW and Bhoori, S and Lee, SG (2008) Liver transplantation for hepatocellular carcinoma. In: UNSPECIFIED UNSPECIFIED, 1001 - 1007. ISBN UNSPECIFIED

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Background: Orthotopic liver transplantation (OLT) is the best available option for early hepatocellular carcinoma (HCC), although its application is limited by stringent selection criteria, costs, and deceased donor graft shortage, particularly in Asia, where living donor liver transplant (LDLT) has been developed. Methods: This article reviews the present standards for patient selection represented by size-and-number criteria with particular references to Milan Criteria and novel prediction models based on results achieved in patients exceeding those limits, with consideration of the expanded indication represented by the UCSF Criteria. Results: The expected outcomes after deceased donor liver transplant (DDLT) or LDLT are favorable if predetermined selection criteria are applied. However, selection bias, difference in waiting time, and ischemia-regeneration injuries of the graft among DDLT vs LDLT may influence long-term results. In the article, the differences between East and West in first-line treatments for HCC (resection vs transplantation), indications, and ethics for the donor, are summarized as well as possible novel predictors of tumor biology (especially DNA mutation and fractional allelic loss, FAI) to be considered for better outcome prediction. Conclusions: Liver transplantation remains the most promising product of modern surgery and represents a cornerstone in the management of patients with HCC. © 2007 The Author(s).


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Item Type: Book Section
Status: Published
CreatorsEmailPitt UsernameORCID
Mazzaferro, V
Chun, YS
Poon, RTP
Schwartz, ME
Yao, FY
Marsh, JW
Bhoori, S
Lee, SG
Centers: Other Centers, Institutes, Offices, or Units > Thomas E. Starzl Transplantation Institute
Date: 1 April 2008
Date Type: Publication
Journal or Publication Title: Annals of Surgical Oncology
Volume: 15
Number: 4
Page Range: 1001 - 1007
DOI or Unique Handle: 10.1245/s10434-007-9559-5
Institution: University of Pittsburgh
Refereed: Yes
ISSN: 1068-9265
Other ID: uls-drl:31735062112234, Starzl CV No. 1431
Date Deposited: 08 Apr 2010 17:24
Last Modified: 05 Feb 2019 05:55


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