Favorable Long-term Outcome in Patients Submitted to Liver Transplantation After Downstaging of Hepatocellular Carcinoma According to a Brazilian Selection Protocol
Carregando...
Citações na Scopus
6
Tipo de produção
article
Data de publicação
2016
Título da Revista
ISSN da Revista
Título do Volume
Editora
ELSEVIER SCIENCE INC
Autores
Citação
TRANSPLANTATION PROCEEDINGS, v.48, n.7, p.2338-2340, 2016
Resumo
Background. In October 2008, the Brazilian Ministry of Health authorized listing of downstaged hepatocellular carcinoma (HCC) for liver transplantation, according to a standardized protocol. The aim of this study was to compare the outcome of patients submitted to liver transplantation after downstaging of HCC with the results other standard indications in Brazil. Methods. We conducted a retrospective analysis of 2,667 adult 1st elective deceased donor liver transplantations registered at the database of the Transplant Notification Center of the Sao Paulo State Health Secretariat. These cases are classified into 3 groups: ""cirrhosis,"" including 1,709 patients transplanted because of end-stage liver disease; ""Milan-HCC,"" including 873 HCC patients initially meeting the Milan criteria; and ""downstaging"" group, including 85 HCC patients submitted to tumor downstaging to the Milan criteria before liver transplantation. Results. One-, 3-, 5-, and 6-year patients survivals were, respectively, 82.7%, 72.0%, 66.1%, and 66.1%, in the ""downstaging"" group and 76.7%, 68.4%, 63.9%, and 63.5% in the ""Milan-HCC"" group (P = .483). At the same time intervals, patient survivals were 67.8%, 62.9%, 60.9%, and 60.2% in the ""cirrhosis"" group. These probabilities were significantly lower than those of both ""downstaging"" (P = .047) and ""Milan-HCC"" (P = .001) groups. Conclusions. Patients submitted to liver transplantation after downstaging of HCC, according to a Brazilian selection protocol, present long-term outcomes similar to HCC patients initially within the Milan criteria and better survival than recipients with end-stage liver disease.
Palavras-chave
Referências
- Mazzaferro V, 1996, NEW ENGL J MED, V334, P693, DOI 10.1056/NEJM199603143341104
- Parikh ND, 2015, LIVER TRANSPLANT, V21, P1142, DOI 10.1002/lt.24169
- Pestana RC, 2013, TRANSPL P, V45, P2111, DOI 10.1016/j.transproceed.2012.11.007
- Shuster A, 2013, J VASC INTERV RADIOL, V24, P805, DOI 10.1016/j.jvir.2013.01.499
- Toso C, 2014, AM J TRANSPLANT, V14, P2221, DOI 10.1111/ajt.12923