Living donor liver transplantation for hepatocellular carcinoma: Tokyo university series
Living donor liver transplantation for hepatocellular carcinoma: Tokyo university series
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DOI：
10.1159/000106910
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发表时间：
2007-01-01
影响因子：
2.3
通讯作者：
Makuuchi, Masatoshi
中科院分区：
文献类型：
--
作者：
Sugawara, Yasuhiko;Tamura, Sumihito;Makuuchi, Masatoshi
背景/目的：肝细胞癌（HCC）是活体肝移植（LDLT）的主要适应症之一。然而，与死亡供体肝移植不同的是，对于LDLT中潜在的HCC候选人，目前还没有普遍采用的选择标准。我们对LDLT中HCC的机构指南是最多5个结节，最大直径为5 cm（5- 5规则）。方法：1996年4月至2005年10月，共有78例成人患者在东京大学接受成人活体肝移植。结果：移植后5年的总体和无复发生存率分别为75%和90%，中位随访时间为2年。当按5- 5规则分层时，符合标准和超过标准的患者3年无复发生存率分别为94%和50%。结论：在LDLT中，HCC的适应症可能从米兰标准扩展，具有相同的结局。然而，还需要进一步的研究来证明5- 5规则的普遍适用性。
Background/Aims: Hepatocellular carcinoma (HCC) is one of the major indications for living donor liver transplantation (LDLT). Unlike in deceased donor liver transplantation, however, there exist no universally adopted selection criteria for the potential candidates with HCC in LDLT. Our institutional guideline for HCC in LDLT has been up to 5 nodules with a maximum diameter of 5 cm (5- 5 rule). Methods: A total of 78 adult patients underwent adult living donor liver transplantation at University of Tokyo between April 1996 and October 2005. Results: Overall and recurrence-free survival at 5 years after transplantation were 75 and 90%, respectively, with a median follow-up of 2 years. When stratified by the 5- 5 rule, recurrence-free survival at 3 years for patients fulfilling the criteria and those exceeding the criteria was 94 and 50%, respectively. Conclusions: In LDLT, the indication for HCC might be expanded from the Milan criteria, with equivalent outcomes. Further study, however, is necessary to justify the general application of the 5- 5 rule.