Dataset Information

Japanese living donor liver transplantation criteria for hepatocellular carcinoma: nationwide cohort study.

ABSTRACT:

Background

Validating the expanded criteria for living donor liver transplantation for hepatocellular carcinoma using national data is highly significant. The aim of this study was to evaluate the validity of the new Japanese criteria for living donor liver transplantation for hepatocellular carcinoma patients and identify factors associated with a poor prognosis using the Japanese national data set.

Methods

The study population comprised patients who underwent living donor liver transplantation for hepatocellular carcinoma at 37 centres in Japan between 2010 and 2018. In a nationwide survey, the overall survival and recurrence-free survival rates were evaluated based on the new Japanese criteria for applying the 5-5-500 rule when extending the indication beyond the Milan criteria. Prognostic factors within the Japanese criteria were determined using the Cox proportional hazards model.

Results

Patients within (485 patients) and beyond (31 patients) the Japanese criteria exhibited 5-year overall survival rates of 81% and 58% and 5-year recurrence-free survival rates of 77% and 48% respectively. Patients who met the Milan criteria, but not the 5-5-500 rule, had poorer outcomes. Multivariate analysis for 474 patients identified a neutrophil-to-lymphocyte ratio greater than or equal to 5 and a history of hepatectomy as independent risk factors.

Conclusion

This nationwide survey confirms the validity of the Japanese criteria. The poor prognostic factors within the Japanese criteria include a neutrophil-to-lymphocyte ratio greater than or equal to 5 and previous hepatectomy.

SUBMITTER: Ohira M

PROVIDER: S-EPMC11295212 | biostudies-literature | 2024 Jul

REPOSITORIES: biostudies-literature

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Publications

Japanese living donor liver transplantation criteria for hepatocellular carcinoma: nationwide cohort study.

Ohira Masahiro M Aoki Gaku G Orihashi Yasushi Y Yoshimura Kenichi K Toshima Takeo T Hatano Etsuro E Eguchi Susumu S Hibi Taizo T Hasegawa Kiyoshi K Umeda Yuzo Y Hashimoto Takuya T Hasegawa Yasushi Y Nobori Shuji S Ogura Yasuhiro Y Nitta Hiroyuki H Egawa Hiroto H Eguchi Hidetoshi H Takada Yasutsugu Y Ueda Yoshihide Y Kasahara Mureo M Kawachi Shigeyuki S Soejima Yuji Y Tokushige Katsutoshi K Nagano Hiroaki H Haga Hironori H Fukumoto Takumi T Mochida Satoshi S Umeshita Koji K Ohdan Hideki H

BJS open 20240701 4

<h4>Background</h4>Validating the expanded criteria for living donor liver transplantation for hepatocellular carcinoma using national data is highly significant. The aim of this study was to evaluate the validity of the new Japanese criteria for living donor liver transplantation for hepatocellular carcinoma patients and identify factors associated with a poor prognosis using the Japanese national data set.<h4>Methods</h4>The study population comprised patients who underwent living donor liver ...[more]

PMID: 39092977

Similar Datasets

Project description:Adult-to-adult living donors and recipients were studied to characterize patterns of liver growth and identify associated factors in a multicenter study. Three hundred and fifty donors and 353 recipients in the Adult-to-Adult Living Donor Liver Transplantation Cohort Study (A2ALL) receiving transplants between March 2003 and February 2010 were included. Potential predictors of 3-month liver volume included total and standard liver volumes (TLV and SLV), Model for End-Stage Liver Disease (MELD) score (in recipients), the remnant and graft size, remnant-to-donor and graft-to-recipient weight ratios (RDWR and GRWR), remnant/TLV, and graft/SLV. Among donors, 3-month absolute growth was 676 ± 251 g (mean ± SD), and percentage reconstitution was 80% ± 13%. Among recipients, GRWR was 1.3% ± 0.4% (8 < 0.8%). Graft weight was 60% ± 13% of SLV. Three-month absolute growth was 549 ± 267 g, and percentage reconstitution was 93% ± 18%. Predictors of greater 3-month liver volume included larger patient size (donors and recipients), larger graft volume (recipients), and larger TLV (donors). Donors with the smallest remnant/TLV ratios had larger than expected growth but also had higher postoperative bilirubin and international normalized ratio at 7 and 30 days. In a combined donor-recipient analysis, donors had smaller 3-month liver volumes than recipients adjusted for patient size, remnant or graft volume, and TLV or SLV (P = 0.004). Recipient graft failure in the first 90 days was predicted by poor graft function at day 7 (HR = 4.50, P = 0.001) but not by GRWR or graft fraction (P > 0.90 for each). Both donors and recipients had rapid yet incomplete restoration of tissue mass in the first 3 months, and this confirmed previous reports. Recipients achieved a greater percentage of expected total volume. Patient size and recipient graft volume significantly influenced 3-month volumes. Importantly, donor liver volume is a critical predictor of the rate of regeneration, and donor remnant fraction affects postresection function. Liver Transpl 21:79-88, 2015. © 2014 AASLD.

Dataset Information

Japanese living donor liver transplantation criteria for hepatocellular carcinoma: nationwide cohort study.

Background

Methods

Results

Conclusion

Publications

Japanese living donor liver transplantation criteria for hepatocellular carcinoma: nationwide cohort study.

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