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©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
Liver transplantation for hepatocellular carcinoma in India: Are we ready for 2040?
Hirak Pahari, Amruth Raj, Ambreen Sawant, Dipak S Ahire, Raosaheb Rathod, Chetan Rathi, Tushar Sankalecha, Sachin Palnitkar, Vikram Raut
Hirak Pahari, Amruth Raj, Vikram Raut, Department of Liver Transplant and HPB Surgery, Medicover Hospitals, Navi Mumbai 410210, Maharashtra, India
Ambreen Sawant, Department of Liver Transplant Anaesthesia, Medicover Hospitals, Navi Mumbai 410210, Maharashtra, India
Dipak S Ahire, Department of Gastroenterology and Hepatology, Medicover Hospitals, Navi Mumbai 410210, India
Raosaheb Rathod, Department of Gastroenterology and Hepatology, Medicover Hospitals, Navi Mumbai 410210, Maharashtra, India
Chetan Rathi, Department of Gastroenterology and Hepatology, Medicover Hospitals, Aurangabad 431003, India
Tushar Sankalecha, Department of Gastroenterology and Hepatology, Medicover Hospitals, Nashik 422009, India
Sachin Palnitkar, Department of Gastroenterology and Hepatology, Medicover Hospitals, Pune 411026, India
Author contributions: Pahari H, Raj A, Raut V and Sawant A contributed in concept, concept design and final discussion. Ahire DS and Rathod R contributed to preparing the survey and analysis of the results. Sankalecha T, Rathi C and Palnitkar S helped in analysis, review of literature and discussion.
Institutional review board statement: This is a survey of various institutions and a review of literature with authors opinion and directly involving any patients. It was reviewed by institutional board and exempted from review.
Informed consent statement: There is no patient information in the article.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: There is no patient information in the article and data of the survey is available on request.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Hirak Pahari, DNB, MBBS, Surgeon, Department of Liver Transplant and HPB Surgery, Medicover Hospitals, Kharghar, Sector 10, Navi Mumbai 410210, Maharashtra, India. hirak.pahari@gmail.com
Received: October 11, 2023
Peer-review started: October 11, 2023
First decision: November 21, 2023
Revised: December 21, 2023
Accepted: January 22, 2024
Article in press: January 22, 2024
Published online: March 18, 2024
ARTICLE HIGHLIGHTS
Research background
Hepatocellular carcinoma (HCC) with chronic liver disease (CLD) is an indication for liver transplantation (LT). However, the overall survival for this condition is low in India, especially due to late presentation.
Research motivation
The various criteria that are established worldwide may lead to comparable outcomes compared to non-HCC patients, but significantly limit the number of patients that can avail this treatment option.
Research objectives
The aim of our study was to establish the current trends and give our opinion as to how to improve the donor pool or increase the access of patients to this life saving treatment option by relaxing stringent criteria while maintaining at least significant survival benefit.
Research methods
We conducted a survey to see the current trend of practices in India with regards to HCC-CLD patients undergoing LT.
Research results
In this survey, we were able to ascertain trends of practice in HCC-CLD patients with respect to LT. We were also able to identify possible pathways to improve access of LT to these patients and improve the overall survival rates of HCC patients in India to make it comparable to other cancers.
Research conclusions
This study shows that majority of patients are still dependent on sub optimal modes of treatment, and less stringent criteria may need to be followed with acceptable outcomes so that we may be able to match the increasing burden on HCC predicted over next 2 decades.
Research perspectives
To make predictions for 2040, we must prepare to arm ourselves with less stringent selection criteria to widen the pool of patients who may undergo transplantation and have a chance of a better outcome.
