Short waitlist time does not adversely impact outcome following liver transplantation for hepatocellular carcinoma

S. D. Chao, J. P. Roberts, M. Farr, F. Y. Yao

Research output: Contribution to journalArticlepeer-review

26 Scopus citations

Abstract

It has been suggested that patients with hepatocellular carcinoma (HCC) undergoing living donor liver transplantation (LDLT) have worse recurrence-free survival compared to deceased donor liver transplantation (CLT), leading to the hypothesis that short waitlist time or fast-tracking may include more aggressive tumors that would have been selected out by traditionally longer waitlist time. The primary aim of the present study was to evaluate the impact of waitlist time on HCC recurrence. The study cohort included 100 patients meeting T2 criteria by imaging before undergoing CLT (n = 90) or LDLT (n = 10). The 5-year recurrence-free probability was 89.9% for the entire cohort, and 91.9%, 90.5% and 86.6%, respectively, for waitlist time of 3 months or less, 3-6 months and > 6 months (p = 0.81). In the Cox proportional hazards model, waitlist time was also not a significant predictor of HCC recurrence. Tumor under-staging was observed in 20.5% of patients with waitlist time 3 months or less and 23.0% for waitlist time > 3 months (p = 0.81). In conclusion, our results failed to show an association between waitlist time and outcome after CLT or LDLT for HCC, and provided evidence disputing a significant role of waitlist time in the selection against HCC with unfavorable tumor biology.

Original languageEnglish (US)
Pages (from-to)1594-1600
Number of pages7
JournalAmerican Journal of Transplantation
Volume7
Issue number6
DOIs
StatePublished - Jun 2007
Externally publishedYes

Keywords

  • Deceased donor
  • Hepatocellular carcinoma
  • Liver transplantation
  • Living donor liver transplantation
  • Waitlist time

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

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