School of Medicine, University of Leeds, Leeds, United Kingdom.
Leeds Liver Unit, St James' University Hospital, Leeds, United Kingdom.
Transpl Int. 2022 Nov 2;35:10802. doi: 10.3389/ti.2022.10802. eCollection 2022.
Cholangiocarcinoma (CCA) is currently a contraindication to liver transplantation (LT) in the United Kingdom (UK). Incidental CCA occurs rarely in some patients undergoing LT. We report on retrospective outcomes of patients with incidental CCA from six UK LT centres. Cases were identified from pathology records. Data regarding tumour characteristics and post-transplant survival were collected. CCA was classified by TNM staging and anatomical location. 95 patients who underwent LT between 1988-2020 were identified. Median follow-up after LT was 2.1 years (14 days-18.6 years). Most patients were male (68.4%), median age at LT was 53 (IQR 46-62), and the majority had underlying PSC (61%). Overall median survival after LT was 4.4 years. Survival differed by tumour site: 1-, 3-, and 5-year estimated survival was 82.1%, 68.7%, and 57.1%, respectively, in intrahepatic CCA ( = 40) and 58.5%, 42.6%, and 30.2% in perihilar CCA ( = 42; = 0.06). 1-, 3-, and 5-year estimated survival was 95.8%, 86.5%, and 80.6%, respectively, in pT1 tumours (28.2% of cohort), and 65.8%, 44.7%, and 31.1%, respectively, in pT2-4 ( = 0.018). Survival after LT for recipients with incidental CCA is inferior compared to usual outcomes for LT in the United Kingdom. LT for earlier stage CCA has similar survival to LT for hepatocellular cancer, and intrahepatic CCAs have better survival compared to perihilar CCAs. These observations may support LT for CCA in selected cases.
胆管癌（CCA）目前是英国（UK）肝移植（LT）的禁忌症。在一些接受 LT 的患者中，偶然发现的 CCA 很少见。我们报告了来自英国 6 个 LT 中心的偶然 CCA 患者的回顾性结果。从病理记录中确定病例。收集了有关肿瘤特征和移植后生存的数据。CCA 根据 TNM 分期和解剖位置进行分类。在 1988 年至 2020 年间，共确定了 95 例接受 LT 的患者。LT 后中位随访时间为 2.1 年（14 天至 18.6 年）。大多数患者为男性（68.4%），LT 时的中位年龄为 53（IQR 46-62），大多数患有潜在的PSC（61%）。LT 后总体中位生存时间为 4.4 年。肿瘤部位不同，生存情况也不同：肝内 CCA（ = 40）的 1、3 和 5 年估计生存率分别为 82.1%、68.7%和 57.1%，而肝门部 CCA（ = 42）分别为 58.5%、42.6%和 30.2%；pT1 肿瘤（队列的 28.2%）的 1、3 和 5 年估计生存率分别为 95.8%、86.5%和 80.6%，而 pT2-4 的分别为 65.8%、44.7%和 31.1%（ = 0.018）。与英国 LT 的一般结果相比，偶然发现的 CCA 患者的 LT 后生存情况较差。LT 治疗早期 CCA 的生存率与 LT 治疗肝细胞癌相似，肝内 CCA 的生存率优于肝门部 CCA。这些观察结果可能支持在某些情况下对 CCA 进行 LT。
