Salvage liver transplantation is a reasonable option for selected patients who have recurrent hepatocellular carcinoma after liver resection.
Salvage liver transplantation is a reasonable option for selected patients who have recurrent hepatocellular carcinoma after liver resection.
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DOI：
10.1371/journal.pone.0036587
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Zheng S
中科院分区：
文献类型：
--
作者：
Hu Z;Zhou J;Xu X;Li Z;Zhou L;Wu J;Zhang M;Zheng S
挽救性肝移植（Salvage liver transplantation，简称EMT）已被报道对原发性肝切除术后复发的肝细胞癌（HCC）患者是可行的，但这一发现仍存在争议。我们回顾性研究了原位肝移植受者的临床特点，并对原位肝移植受者与原发性肝移植（PLT）受者进行了比较。一项回顾性研究检查了中国肝移植登记处（CLTR）从1999年1月至2009年12月进行的6，975例移植的数据。共有6，087名患者接受了PLT，888名患者接受了复发性血小板减少性紫癜。389例患者进行了活体肝移植（LDLT），6，586例患者进行了死亡供体肝移植（DDLT）。Kaplan-Meier曲线用于比较生存率。结果：1年、3年、5年生存率分别为73.00%、51.77%、45.84%和74.49%、55.10%、48.81%（P = 0.260）。 结果：1年、3年、5年无病生存率分别为64.79%、45.57%、37.78%，低于PLT组的66.39%、50.39%、43.50%（P = 0.048）。 在LDLT和DDLT受者中，观察到了类似的生存结果，即血小板和血小板。LDLT和DDLT受者的1年、3年和5年总生存率相似：93.33%、74.67%和74.67% vs. 80.13%、62.10%和54.18%（P = 0.281），无病生存率相似：84.85%、62.85%和62.85% vs. 70.54%、53.94%和43.57%（P = 0.462）。 我们的研究表明，对于选定的患者，顺铂有类似的生存PLT，表明顺铂是可以接受的肝切除术后复发性肝癌患者。鉴于器官供体库有限，补救性LDLT可能被视为一种可能的治疗方法。
Salvage liver transplantation (SLT) has been reported as being feasible for patients who develop recurrent hepatocellular carcinoma (HCC) after primary liver resection, but this finding remains controversial. We retrospectively studied the clinical characteristics of SLT recipients and conducted a comparison between SLT recipients and primary liver transplantation (PLT) recipients. A retrospective study examined data from the China Liver Transplant Registry (CLTR) for 6,975 transplants performed from January 1999 to December 2009. A total of 6,087 patients underwent PLT and 888 patients underwent SLT for recurrence. Living donor liver transplantation (LDLT) was performed in 389 patients, while 6,586 patients underwent deceased donor liver transplantation (DDLT). Kaplan-Meier curves were used to compare survival rates. The 1-year, 3-year, and 5-year overall survival of SLT recipients was similar to that of PLT recipients: 73.00%, 51.77%, and 45.84% vs. 74.49%, 55.10%, and 48.81%, respectively (P = 0.260). The 1-year, 3-year and 5-year disease-free survival of SLT recipients was inferior to that of PLT recipients: 64.79%, 45.57%, and 37.78% vs. 66.39%, 50.39%, and 43.50%, respectively (P = 0.048). Similar survival results were observed for SLT and PLT within both the LDLT and DDLT recipients. Within the SLT group, the 1-year, 3-year, and 5-year overall survival for LDLT and DDLT recipients was similar: 93.33%, 74.67%, and 74.67% vs. 80.13%, 62.10%, and 54.18% (P = 0.281), as was the disease-free survival: 84.85%, 62.85%, and 62.85% vs. 70.54%, 53.94%, and 43.57% (P = 0.462). Our study demonstrates that for selected patients, SLT has similar survival to that of PLT, indicating that SLT is acceptable for patients with recurrent HCC after liver resection. Given the limited organ donor pool, salvage LDLT might be considered as a possible treatment.
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