TY - JOUR
T1 - Impact of liver-directed therapy and non-therapy on the waiting time list of patient candidates for liver transplantation
T2 - retrospective survival analysis
AU - del Pilar Bayona Molano, Maria
AU - Garza, Lorena
AU - Selvaggi, Genaro
AU - Vasani, Jay
AU - Gutierrez, Juan Carlos Barrera
AU - Salsamendi, Jason
AU - Bhatia, Shivank
AU - Arosemena, Leopoldo
N1 - Publisher Copyright:
© 2020 Termedia Publishing House Ltd.. All rights reserved.
PY - 2021
Y1 - 2021
N2 - Aim of the study: To determine whether liver-directed therapies (LDT) and no therapy affect waiting list times for liver transplant candidates from a single center. Material and methods: This retrospective study included patients > 12 years of age diagnosed with hepatocellular carcinoma between January 2014 and June 2019 and followed until the date of transplant, date of delisting, loss to follow-up, or date of death. Waiting list time and associated factors were analyzed using Kaplan-Meier and Cox proportional-hazards methods. Results: A total of 181 patients met the selection criteria. The mean age was 60 years with standard deviation (SD) of 7.8 years. Sixty-six percent underwent transplant, and 64% were classified within the Milan criteria. Men had a lower median waiting list time than women (191 days vs. 236 days, p = 0.0093). The overall median survival time or time to transplant for 50% of the population was 218 days (95% CI: 195-235). Men displayed a 3.1-fold (95% CI: 1.5-6.2) higher probability of transplantation than women (p = 0.002). Patients who received no therapy had a 5-fold higher probability of undergoing transplantation than patients under arterial LDT (HR [95% CI]: 5 [1.2, 20], p = 0.02). Patients under combined LDT displayed a 70% reduced probability of transplantation compared to patients who received arterial LDTs (p = 0.0009). Conclusions: LDT was associated with a prolonged stay on the transplant list, likely due to the presence of an aggressive liver tumor. However, LDTs allow the patient to remain active on the liver transplant list, increasing their chances of undergoing transplantation.
AB - Aim of the study: To determine whether liver-directed therapies (LDT) and no therapy affect waiting list times for liver transplant candidates from a single center. Material and methods: This retrospective study included patients > 12 years of age diagnosed with hepatocellular carcinoma between January 2014 and June 2019 and followed until the date of transplant, date of delisting, loss to follow-up, or date of death. Waiting list time and associated factors were analyzed using Kaplan-Meier and Cox proportional-hazards methods. Results: A total of 181 patients met the selection criteria. The mean age was 60 years with standard deviation (SD) of 7.8 years. Sixty-six percent underwent transplant, and 64% were classified within the Milan criteria. Men had a lower median waiting list time than women (191 days vs. 236 days, p = 0.0093). The overall median survival time or time to transplant for 50% of the population was 218 days (95% CI: 195-235). Men displayed a 3.1-fold (95% CI: 1.5-6.2) higher probability of transplantation than women (p = 0.002). Patients who received no therapy had a 5-fold higher probability of undergoing transplantation than patients under arterial LDT (HR [95% CI]: 5 [1.2, 20], p = 0.02). Patients under combined LDT displayed a 70% reduced probability of transplantation compared to patients who received arterial LDTs (p = 0.0009). Conclusions: LDT was associated with a prolonged stay on the transplant list, likely due to the presence of an aggressive liver tumor. However, LDTs allow the patient to remain active on the liver transplant list, increasing their chances of undergoing transplantation.
KW - Hepatocellular carcinoma
KW - Liver transplant
KW - Liver-directed therapies
KW - Waiting list time
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U2 - 10.5114/ceh.2020.102175
DO - 10.5114/ceh.2020.102175
M3 - Article
C2 - 33511277
AN - SCOPUS:85100039763
SN - 2392-1099
VL - 6
SP - 304
EP - 312
JO - Clinical and Experimental Hepatology
JF - Clinical and Experimental Hepatology
IS - 4
ER -