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 27 May 2018

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News

A short waitlist time does not affect the outcome of liver transplantation for HCC recurrence

June's issue of the American Journal of Transplantation evaluates the impact of waitlist time on HCC recurrence.

News image

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It has been suggested that patients with hepatocellular carcinoma (HCC) undergoing living donor liver transplantation (LDLT) have worse recurrence-free survival, compared to deceased donor liver transplantation (CLT).

This led to the hypothesis that short waitlist time, or fast-tracking, may include more aggressive tumors - that would have been selected-out by traditional longer waitlist time.

Dr Francis Y. Yao and colleagues from the USA evaluated the impact of waitlist time on HCC recurrence.

5-y survival was 86.6% for a waitlist time of 6 months.
American Journal of Transplantation

The study cohort included 100 patients meeting T2 criteria by imaging before undergoing CLT (n = 90) or LDLT (n = 10).

The 5-year recurrence-free probability was 89.9% for the entire cohort, and 91.9%, 90.5% and 86.6%, respectively, for waitlist time of 3 months or less, 3-6 months and > 6 months (p = 0.81).

In the Cox proportional hazards model, waitlist time was also not a significant predictor of HCC recurrence.

Tumor under-staging was observed in 20.5% of patients with waitlist time 3 months or less and 23.0% for waitlist time > 3 months (p = 0.81).

Dr Yao concluded that, "Our results failed to show an association between waitlist time and outcome after CLT or LDLT for HCC, and provided evidence disputing a significant role of waitlist time in the selection against HCC with unfavorable tumor biology".

American Journal of Transplantation 2007; 7 (6), 1594-1600
08 June 2007

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