Tanwar S, Khan SA, Grover VPB, Gwilt C, Smith B, Brown A. Liver transplantation for hepatocellular carcinoma. World J Gastroenterol 2009; 15(44): 5511-5516 [PMID: 19938188 DOI: 10.3748/wjg.15.5511]
Corresponding Author of This Article
Dr. Ashley Brown, Department of Hepatology and Gastroenterology, Imperial College London, St Mary’s Hospital Campus, Praed Street, London W2 1NY, United Kingdom. ashley.brown@imperial.nhs.uk
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World J Gastroenterol. Nov 28, 2009; 15(44): 5511-5516 Published online Nov 28, 2009. doi: 10.3748/wjg.15.5511
Liver transplantation for hepatocellular carcinoma
Sudeep Tanwar, Shahid A Khan, Vijay Paul Bob Grover, Catherine Gwilt, Belinda Smith, Ashley Brown
Sudeep Tanwar, Shahid A Khan, Vijay Paul Bob Grover, Catherine Gwilt, Belinda Smith, Ashley Brown, Department of Hepatology and Gastroenterology, Imperial College London, St Mary’s Hospital Campus, Praed Street, London W2 1NY, United Kingdom
Author contributions: All authors generated the ideas and contributed to the writing of this manuscript; Tanwar S and Khan SA performed the original literature search; Grover VPB and Gwilt C contributed to collation of data; Smith B and Brown A reviewed and verified the whole manuscript.
Supported by NIHR Biomedical Research Centre funding scheme, Grants from the Higher Education Funding Council for England, the British Liver Trust and the Alan Morement Memorial Fund, Essex, United Kingdom; the British Medical Association (Gunton Award)
Correspondence to: Dr. Ashley Brown, Department of Hepatology and Gastroenterology, Imperial College London, St Mary’s Hospital Campus, Praed Street, London W2 1NY, United Kingdom. ashley.brown@imperial.nhs.uk
Telephone: +44-207-8866454 Fax: +44-207-7249369
Received: June 25, 2009 Revised: August 14, 2009 Accepted: August 21, 2009 Published online: November 28, 2009
Abstract
Hepatocellular carcinoma (HCC) is the commonest primary malignancy of the liver. It usually occurs in the setting of chronic liver disease and has a poor prognosis if untreated. Orthotopic liver transplantation (OLT) is a suitable therapeutic option for early, unresectable HCC particularly in the setting of chronic liver disease. Following on from disappointing initial results, the seminal study by Mazzaferro et al in 1996 established OLT as a viable treatment for HCC. In this study, the “Milan criteria” were applied achieving a 4-year survival rate similar to OLT for benign disease. Since then various groups have attempted to expand these criteria whilst maintaining long term survival rates. The technique of living donor liver transplantation has evolved over the past decade, particularly in Asia, and published outcome data is comparable to that of OLT. This article will review the evidence, indications, and the future direction of liver transplantation for liver cancer.
