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Clinical Outcomes of Living Donor Liver transplantation for Hepatocellular Carcinoma in Egypt |
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PP: 39-45 |
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doi:10.18576/ab/020203
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Author(s) |
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Mohamed Heneish,
Abduh Elbanna,
Magdy Salah,
Akshaya Srikanth Bhagavathul,
Abd Elrazek Abd Elrazek,
Khaled Amer,
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Abstract |
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| Background: Over the last decade, there has been considerable improvement in the outcome of liver transplantation in patients with Hepatocellular carcinoma (HCC). Aim: To evaluation the prognosis of living donor liver transplantation (LDLT) as a definitive treatment of HCC in patients who met criteria of transplantation including the recurrence of HCC in Egypt. Methods: We retrospective analysed preoperative, operative, post-operative and follow-up records of liver transplanted patients’ attending hepato-pancreato-biliary (HPB) surgery department at International Medical Center (IMC), Egypt from April 1, 2013 to the December 31, 2016. During this period, 53 patients underwent LDLT and hepatic focal lesions (FLs) were the indication of liver transplantation in all the cases. Descriptive and analytical statistics were applied to summarize the findings and Kaplan-Meier survival analysis was performed to investigate the survival rates in LDLT recipients. A pvalue <0.05 was considered statistical significant. Results: Of 53 LDLT recipients, 50 (94.3%) were male, mean age of 52±7.64 years and a majority (86.8%) of the patients were HCV positive. However, nearly three-forth (73.6%) of the patients have comorbidities at the time of transplantation and the mean model for end-stage liver disease (MELD) score was 17.3± 6.1 (range: 8 – 35). Nineteen (35.8%) patients developed recurrent HCV after transplantation and nine (17%) had faced transplant rejection. After one year of LDLT, 64.1% of recipients survived, 58.49% for three years, and 39.6% for five years. One year mortality was 35.8% (19 cases), 41.5% (22 cases) in three years and on five years it reached to 60.3% (32 cases). Conclusion: This studies identified that the success of LDLT in HCC patients rely on a stepwise approach that incorporates morphological and biological criteria of the tumor. Major vascular invasion, massive infiltrative type, ruptured HCC and distant metastasis are to be considered as absolute contraindications for transplant. |
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