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Living donor liver transplantation for Patients with beyond Milan hepatocellular carcinoma

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dc.contributor.author김, 봉완-
dc.contributor.author배, 병구-
dc.contributor.author박, 용근-
dc.contributor.author원, 재환-
dc.contributor.author배, 재익-
dc.contributor.author허, 위광-
dc.contributor.author왕, 희정-
dc.contributor.author김, 명욱-
dc.date.accessioned2014-01-21T01:30:03Z-
dc.date.available2014-01-21T01:30:03Z-
dc.date.issued2008-
dc.identifier.issn1738-6349-
dc.identifier.urihttp://repository.ajou.ac.kr/handle/201003/9015-
dc.description.abstractBackground: To find the patients who have a significant chance of cure with living donor liver transplantation (LDLT) among the patients suffering with beyond-Milan hepatocellular carcinoma (HCC), we retrospectively analyzed the tumor factors that could affect a good prognosis after LDLT for patients who suffer with beyond Milan HCC.



Methods: Between March 2005 and May 2007, 18 cases of LDLT for beyond Milan HCC were performed. None of the patients had preoperative radiological evidence of vascular invasion. Excluding the 3 cases of in-hospital mortality, we analyzed the survival, the disease-free survival and the prognostic factors for recurrence in 15 beyond Milan HCC patients. The mean follow-up period was 18.8 °± 8.8 months (range: 4-34 months).



Results: The two-year survival and disease-free survival rates after LDLT were 61.7% and 31.1%, respectively, in 15 beyond-Milan patients. Among them, 9 patients had recurrence of HCC during follow-up. The one-year survival rate after tumor recurrence was 55.5%. An alphafetoprotein (AFP) level < 400 ng/mL, Edmonson-Steiner histology grade I and II and the presence of graft rejection were analyzed as the good prognostic factors of disease-free survival after LDLT for beyond-Milan HCC (p < .05). The patients with negative preoperative positron emission tomography (PET) findings (n = 5) showed a better prognosis than the PET-positive patients (n = 10) with statistical significance (p = .05).



Conclusion: Allowing that HCC patients exceed the Milan criteria, we can find the potentially curable candidates for LDLT with using tumor biologic markers such as a serum AFP level < 400 ng/mL, negative PET uptake or low grade histology, as assessed by preoperative needle biopsy. Further investigation is needed to evaluate the relation between graft rejection and tumor recurrence after liver transplantation.
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dc.language.isoko-
dc.titleLiving donor liver transplantation for Patients with beyond Milan hepatocellular carcinoma-
dc.title.alternativeMilan 기준을 넘는 간세포암에서 생체부분 간이식-
dc.typeArticle-
dc.identifier.urlhttp://www.kahbps.or.kr/journal/view.html?uid=633&start=0&sort=Regnum-0&scale=10&key=&oper=&key_word=&year=2008&year1=&year2=&Vol=012&Num=03&PG=&book=Journal&mod=vol&sflag=&sub_box=Y&aut_box=Y&sos_box=&pub_box=Y&key_box=&abs_box=-
dc.subject.keyword간세포암-
dc.subject.keyword생체부분 간이식-
dc.subject.keywordLiver transplantation-
dc.subject.keywordLiving Donors-
dc.subject.keywordMilan criteria-
dc.subject.keywordHCC-
dc.subject.keywordHepatocellular carcinoma-
dc.contributor.affiliatedAuthor김, 봉완-
dc.contributor.affiliatedAuthor배, 병구-
dc.contributor.affiliatedAuthor원, 제환-
dc.contributor.affiliatedAuthor배, 재익-
dc.contributor.affiliatedAuthor왕, 희정-
dc.contributor.affiliatedAuthor김, 명욱-
dc.type.localJournal Papers-
dc.citation.titleKorean journal of hepato-biliary-pancreatic surgery-
dc.citation.volume12-
dc.citation.number3-
dc.citation.date2008-
dc.citation.startPage162-
dc.citation.endPage167-
dc.identifier.bibliographicCitationKorean journal of hepato-biliary-pancreatic surgery, 12(3):162-167, 2008-
dc.identifier.eissn2288-9213-
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Radiology
Journal Papers > School of Medicine / Graduate School of Medicine > Surgery
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