Chen Jun, Xu Xiao, Wu Jian, Ling Qi, Wang Kai, Wang Weilin, Zhang Min, Shen Yan, Zhou Lin, Xie Haiyang, Zheng Shusen
Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China; Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang Province, China.
PLoS One. 2014 Mar 27;9(3):e93128. doi: 10.1371/journal.pone.0093128. eCollection 2014.
BACKGROUND/AIMS: The selection criteria for patients with hepatocellular carcinoma (HCC) as candidates for deceased donor liver transplantation (DDLT) are well studied. In this era of limited deceased donor organs, the value of living donor liver transplantation (LDLT) for HCC remains controversial. The aim of the present study was to verify the stratification value of the Hangzhou criteria for LDLT.
The data of 47 LDLT recipients and 94 matched DDLT recipients at our center were evaluated. Overall survival and tumor-free survival were calculated. Prognostic factors influencing post-liver transplantation (LT) survival were identified. The stratification values of the Hangzhou criteria and Milan criteria were compared.
LDLT recipients spent much less time on the waiting list. The post-LT survival of recipients fulfilling the Milan criteria and recipients fulfilling the Hangzhou criteria were comparable (P>0.05). The overall and tumor-free survival did not differ statistically between the two groups. In both groups, more recipients not meeting the Milan criteria but with a satisfactory outcome were identified by the Hangzhou criteria. Among recipients who did not meet the Hangzhou criteria, tumor-free survival was better for the LDLT recipients than the DDLT recipients (P = 0.024).
The Hangzhou criteria are reliable for stratifying HCC patients in terms of prognosis. HCC patients fulfilling the Hangzhou criteria gain satisfactory survival from LT. Outcomes after LDLT are better than those after DDLT for HCC patients who do not meet the Hangzhou criteria.
背景/目的：肝细胞癌（HCC）患者作为尸体供肝肝移植（DDLT）候选者的选择标准已得到充分研究。在这个尸体供肝有限的时代，活体供肝肝移植（LDLT）对HCC的价值仍存在争议。本研究的目的是验证杭州标准对LDLT的分层价值。
评估了本中心47例LDLT受者和94例匹配的DDLT受者的数据。计算总生存率和无瘤生存率。确定影响肝移植（LT）后生存的预后因素。比较了杭州标准和米兰标准的分层价值。
LDLT受者在等待名单上花费的时间要少得多。符合米兰标准的受者和符合杭州标准的受者LT后的生存率相当（P>0.05）。两组的总生存率和无瘤生存率在统计学上没有差异。在两组中，杭州标准识别出更多未符合米兰标准但结局良好的受者。在未符合杭州标准的受者中，LDLT受者的无瘤生存率高于DDLT受者（P = 0.024）。
杭州标准在对HCC患者进行预后分层方面是可靠的。符合杭州标准的HCC患者LT后获得了满意的生存率。对于未符合杭州标准的HCC患者，LDLT后的结局优于DDLT。
