RISK FACTORS ASSOCIATED WITH DELISTING OF HEPATOCELLULAR CARCINOMA PATIENT'S CANDIDATES FOR LIVER TRANSPLANTATION | ||||
| Journal of the Egyptian Society of Parasitology | ||||
| Article 29, Volume 50, Issue 3, December 2020, Page 706-711 PDF (781.83 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/jesp.2020.131119 | ||||
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| Authors | ||||
| RASHA SAMIR MOHAMED1; KHALED ZAKARIA EL-KARMOUTY1; MOHAMED MOHAMED BAHAA ELDIN AHMED2; ENGY EZZAT ESKANDAR1; HESHAM HAMDY El KILANY1; HANY SAMIR RASMY1 | ||||
| 1Department of Internal Medicine | ||||
| 2Department of Surgery | ||||
| Abstract | ||||
| Hepatocellular carcinoma (HCC) is the sixth most common cancer worldwide, with more than 1 million new cases diagnosed every year. Liver transplantation has been used as a curative treatment for patients with HCC. Liver transplantation offers the best cure chance for unrespectable hepatocellular carcinoma (HCC), but the scarcity of cadaver liver grafts has seriously limited its role. With the recent advances in adult living donor liver transplantation (LDLT), there is potentially a drastic change in the role of liver transplantation. Recent Studies have demonstrated the theoretical survival benefit of LDLT over deceased donor liver transplantation (DDLT) which depends largely on the waiting time and drop‐out rate. This study was conducted to analyze the different risk factors leading to delisting in liver transplant patients with hepatocellular carcinoma. Fifty patients presented to Ain Shams Specialized Hospitals from January 2017 to June 2018, with expected average hepatocellular carcinoma eligible for Adult Living Donor Liver transplantation (ALDLT) were studied. They were evaluated according to protocol of Ain Shams Center of Organ Transplantation (ASCOT). Inclusion criteria: 1-hepatocellular carcinoma with any underlying cause of cirrhosis. HCC is first diagnosed using spiral computed tomography of liver and sometimes Magnetic Resonance Imaging (MRI). 2- Patients within University of California San Francisco (UCSF) criteria (one tumor ≤6·5 cm, three nodules with largest ≤4·5cm, & total tumor diameter ≤8 cm). 3- Patients within these criteria underwent loco-regional therapy as bridging therapy including radiofrequency ablation, radio-embolization, trans-arterial chemoembolization, microwave ablation or liver resection to avoid delisting. 4- Patients beyond these criteria underwent loco-regional treatment as means of down staging to be within Milan or UCSF and candidates for ALDLT. Exclusion criteria: 1- metastatic HCC patients, 2- macrovascular invasion, & 3- poor general condition for surgery. | ||||
| Keywords | ||||
| Transplantation; Priority; Hepatocellular carcinoma; Delisting | ||||
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