Eguchi Susumu, Hidaka Masaaki, Hara Takanobu, Matsushima Hajime, Soyama Akihiko
Department of Surgery Nagasaki University Graduate School of Biomedical Sciences Nagasaki Japan.
Ann Gastroenterol Surg. 2022 Mar 23;6(5):616-622. doi: 10.1002/ags3.12567. eCollection 2022 Sep.
Liver transplantation (LT) for non-hepatocellular carcinoma is still a debatable indication. Recently, hilar cholangiocellular carcinoma (hCCC) has attracted interest as a new indication for LT, but LT in this case should be carefully considered. Based on the recent meta-analysis for intrahepatic CCC (IHCCC) and our results from incidental IHCCC transplanted for other diseases such as primary sclerosing cholangitis, the indication for LT for IHCCC should be limited to a single tumor less than 2 cm. For hCCC, with pre-transplant chemoradiotherapy and careful selection criteria, long-term survival after LT could be attained. In order to improve the results of LT for intrahepatic and hCCC, further studies are required on the ingenuity of immunosuppressive therapy combined with chemotherapy, and optimal treatment methods to prevent recurrence, as well as initial case selection.
非肝细胞癌的肝移植（LT）仍是一个有争议的适应证。最近，肝门部胆管细胞癌（hCCC）作为LT的新适应证引起了关注，但对此类病例进行LT时应谨慎考虑。基于最近对肝内胆管细胞癌（IHCCC）的荟萃分析以及我们对因原发性硬化性胆管炎等其他疾病而偶然进行移植的IHCCC的研究结果，IHCCC的LT适应证应限于单个直径小于2厘米的肿瘤。对于hCCC，通过移植前放化疗和仔细的选择标准，可以实现LT后的长期生存。为了改善肝内和hCCC的LT效果，需要进一步研究免疫抑制治疗与化疗相结合的策略、预防复发的最佳治疗方法以及初始病例选择。
