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Predictors of Outcome of Living Donor Liver Transplantation for Hepatocellular Carcinoma

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Abstract

The aim of this work is to study the different factors that affect the outcome of living donor liver transplantation for patients with hepatocellular carcinoma (HCC). Between April 2003 to November 2014, 62 patients with liver cirrhosis and HCC underwent living donor liver transplantation (LDLT) in the National Liver Institute, Menoufia University, Egypt. The preoperative, operative, and postoperative data were analyzed. After studying the pathology of explanted liver; 44 (71 %) patients were within the Milan criteria, and 18 (29 %) patients were beyond Milan; 13 (21.7 %) of patients beyond the Milan criteria were also beyond the University of California San Francisco criteria (UCSF) criteria. Preoperative ablative therapy for HCC was done in 22 patients (35.5 %), four patients had complete ablation with no residual tumor tissues. Microvascular invasion was present in ten patients (16 %) in histopathological study. Seven (11.3 %) patients had recurrent HCC post transplantation. The 1, 3, 5 years total survival was 88.7, 77.9, 67.2 %, respectively, while the tumor-free survival was 87.3, 82.5, 77.6 %, respectively. Expansion of selection criteria beyond Milan and UCSF had no increased risk effect on recurrence of HCC but had less survival rate than patients within the Milan criteria. Microvascular invasion was an independent risk factor for tumor recurrence.

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Authors and Affiliations

  1. Department of Hepato-pancreao-biliary & Liver Transplantation Surgery, National Liver Institute, Menoufia University, 32511, Shebin El-koom, Menoufia, Egypt

    Hazem Mohamed Zakaria, Ahmed N. Sallam, Islam I. Ayoub, Sherif M. Saleh, Mohamed Abou-Shady, Ibrahim A. Salama, El-Sayed A. Soliman, Khaled Abou El-Ella, Tarek M. Ibrahim & Essam M. Hammad

  2. Department of Pathology, National Liver Institute, Menoufia University, 32511, Shebin El-koom, Menoufia, Egypt

    Doha Maher

  3. Department of Diagnostic and Interventional Radiology, National Liver Institute, Menoufia University, 32511, Shebin El-koom, Menoufia, Egypt

    Hazem Omar

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  1. Hazem Mohamed Zakaria
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  2. Ahmed N. Sallam
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  3. Islam I. Ayoub
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  4. Sherif M. Saleh
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  6. Hazem Omar
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  7. Mohamed Abou-Shady
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  8. Ibrahim A. Salama
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  9. El-Sayed A. Soliman
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  10. Khaled Abou El-Ella
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  11. Tarek M. Ibrahim
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  12. Essam M. Hammad
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Correspondence to Hazem Mohamed Zakaria.

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Zakaria, H.M., Sallam, A.N., Ayoub, I.I. et al. Predictors of Outcome of Living Donor Liver Transplantation for Hepatocellular Carcinoma. Indian J Surg 79, 299–307 (2017). https://doi.org/10.1007/s12262-016-1474-1

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  • DOI: https://doi.org/10.1007/s12262-016-1474-1

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