Expanded criteria for liver transplantation in patients with hepatocellular carcinoma
Expanded criteria for liver transplantation in patients with hepatocellular carcinoma
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扩大肝细胞癌患者肝移植的标准
DOI：
10.1111/j.1872-034x.2007.00195.x
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发表时间：
2007
影响因子：
4.2
通讯作者：
F. Yao
中科院分区：
文献类型：
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作者：
F. Yao
在意大利米兰的研究小组发表了一套针对肝细胞癌患者进行原位肝移植的限制性标准，以限制肿瘤复发的风险之后，许多中心使用类似或略高于米兰标准的标准(单个病变为≤5 cm，或2-3个≤3 cm)，报告了肝移植后患者出色的5年存活率超过70%。越来越多的肝细胞癌原位肝移植的经验和成功也引发了关于根据肿瘤大小和数量扩大身体或活体供体肝移植的传统标准的争议。影像研究的局限性，例如高达25%的患者肿瘤分期不足，一直是放宽目前肝移植标准的主要担忧。加州大学旧金山分校的标准(单个病灶≤6.5 cm，或2-3个≤4.5 cm，肿瘤总直径≤8 cm)已经在多项研究中进行了独立测试，并根据术前影像进行了前瞻性评估。这篇文章提供了一个关于扩大现有肝移植标准的已发表数据的深入综述。
Following the seminal publication by the group from Milan, Italy using a restrictive set of criteria for orthotopic liver transplantation in patients with hepatocellular carcinoma to limit the risk for tumor recurrence, excellent 5‐year patient survival of greater than 70% after liver transplantation has been reported from many centers using criteria similar to or slightly exceeding the Milan criteria (single lesion of ≤5 cm, or 2–3 lesions of ≤3 cm). The growing experience and success of orthotopic liver transplantation for HCC have also fueled controversies related to expansion of conventional criteria for cadaveric or living‐donor liver transplantation based on tumor size and number. The limitations of imaging studies, exemplified by tumor under‐staging in up to 25% of patients,have been a major concern for liberalizing the current criteria for liver transplantation. The University of California, San Francisco criteria (single lesion of ≤6.5 cm, or 2–3 lesions of ≤4.5 cm with a total tumor diameter ≤8 cm) have been independently tested in several studies, and undergone prospective evaluation based on preoperative imaging. This article provides an in‐depth review of published data on expansion of current criteria for liver transplantation.
Jiang, R., et al.：“羟基脲对 EBV 感染的上消化道细胞系与伯基特淋巴瘤细胞系中 Epstein-Barr 病毒 (EBV) 基因组减少的影响对比”J.
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