Retrospective Study
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World J Gastroenterol. Aug 21, 2014; 20(31): 10953-10959
Published online Aug 21, 2014. doi: 10.3748/wjg.v20.i31.10953
Living donor liver transplantation does not increase tumor recurrence of hepatocellular carcinoma compared to deceased donor transplantation
Guang-Qin Xiao, Jiu-Lin Song, Shu Shen, Jia-Yin Yang, Lu-Nan Yan
Guang-Qin Xiao, Jiu-Lin Song, Shu Shen, Jia-Yin Yang, Lu-Nan Yan, Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Xiao GQ, Song JL, and Shen S contributed equally to this study; Xiao GQ and Yan LN conceived and designed the study; Xiao GQ, Song JL, Shen S, and Yang JY collected data, performed patient follow-up, analyzed the data, and drafted the article; Yan LN and Yang JY revised the manuscript and obtained funding; Xiao GQ, Song JL, Shen S, Yang JY, and Yan LN acquired data, provided technical support, and were involved in the editing of the manuscript.
Supported by National Science and Technology Major Project of China, No. 2012ZX10002-016 and No. 2012ZX10002017-017
Correspondence to: Lu-Nan Yan, MD, PhD, Liver Transplantation Center, West China Hospital of Sichuan University, Nanguoxue, Xiang No. 37, Wuhou District, Chengdu 610041, Sichuan Province, China. yanlunan1268@163.com
Telephone: +86-28-85422867 Fax: +86-28-85422867
Received: November 9, 2013
Revised: March 15, 2014
Accepted: May 23, 2014
Published online: August 21, 2014
Abstract

AIM: To compare the recurrence-free survival (RFS) and overall survival (OS) of hepatitis B virus (HBV)-positive hepatocellular carcinoma (HCC) after living donor liver transplantation (LDLT) and deceased donor liver transplantation (DDLT).

METHODS: We retrospectively collected clinical data from 408 liver cancer patients from February 1999 to September 2012. We used the chi-squared test or Fisher’s exact test to analyze the characteristics of LDLT and DDLT. Kaplan-Meier analysis was used to compare the RFS and OS in HCC.

RESULTS: Three hundred sixty HBV-positive patients (276 DDLT and 84 LDLT) were included in this study. The mean follow-up time was 27.1 mo (range 1.1-130.8 mo). One hundred eighty-five (51.2%) patients died during follow-up. The 1-, 3-, and 5-year RFS rates for LDLT were 85.2%, 55.7%, and 52.9%, respectively; for DDLT, the RFS rates were 73.2%, 49.1%, and 45.3% (P = 0.115). The OS rates were similar between the LDLT and DDLT recipients, with 1-, 3-, and 5-year survival rates of 81.8%, 49.5%, and 43.0% vs 69.5%, 43.0%, and 38.3%, respectively (P = 0.30). The outcomes of HCC according to the Milan criteria after LDLT and DDLT were not significantly different (for LDLT: 1-, 3-, and 5-year RFS: 94.7%, 78.7%, and 78.7% vs 89.2%, 77.5%, and 74.5%, P = 0.50; for DDLT: 86.1%, 68.8%, and 68.8% vs 80.5%, 62.2%, and 59.8% P = 0.53).

CONCLUSION: The outcomes of LDLT for HCC are not worse compared to the outcomes of DDLT. LDLT does not increase tumor recurrence of HCC compared to DDLT.

Keywords: Hepatocellular carcinoma, Living donor, Deceased donor, Liver transplantation, Hepatitis B virus

Core tip: Whether there is a higher tumor recurrence for living donor liver transplantation (LDLT) than for deceased donor liver transplantation (DDLT) for hepatocellular carcinoma (HCC) has recently become a subject of debate. Our results suggest that LDLT does not increase the tumor recurrence of HCC compared to DDLT. The recurrence-free survival and long-term survival times of LDLT for HCC are higher than those of DDLT.