Department of Surgery, Swiss HPB and Transplant Centers, University Hospital Zurich, Zurich, Switzerland.
Lancet Oncol. 2012 Jan;13(1):e11-22. doi: 10.1016/S1470-2045(11)70175-9. Epub 2011 Oct 31.
Although liver transplantation is a widely accepted treatment for hepatocellular carcinoma (HCC), much controversy remains and there is no generally accepted set of guidelines. An international consensus conference was held on Dec 2-4, 2010, in Zurich, Switzerland, with the aim of reviewing current practice regarding liver transplantation in patients with HCC and to develop internationally accepted statements and guidelines. The format of the conference was based on the Danish model. 19 working groups of experts prepared evidence-based reviews according to the Oxford classification, and drafted recommendations answering 19 specific questions. An independent jury of nine members was appointed to review these submissions and make final recommendations, after debates with the experts and audience at the conference. This report presents the final 37 statements and recommendations, covering assessment of candidates for liver transplantation, criteria for listing in cirrhotic and non-cirrhotic patients, role of tumour downstaging, management of patients on the waiting list, role of living donation, and post-transplant management.
虽然肝移植是治疗肝细胞癌(HCC)的一种广泛接受的方法,但仍存在许多争议,并且没有普遍接受的一套指南。2010 年 12 月 2 日至 4 日,在瑞士苏黎世举行了一次国际共识会议,旨在审查目前对 HCC 患者进行肝移植的实践,并制定国际认可的声明和指南。会议的形式基于丹麦模式。19 个专家组根据牛津分类法编写了循证审查,并起草了建议,回答了 19 个具体问题。一个由 9 名成员组成的独立评审团被任命对这些提交的内容进行审查,并在会议上与专家和观众进行辩论后提出最终建议。本报告介绍了最终的 37 条声明和建议,涵盖了肝移植候选人的评估、肝硬化和非肝硬化患者的列入标准、肿瘤降级的作用、等待名单上患者的管理、活体捐赠的作用以及移植后的管理。