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World J Gastroenterol. May 14, 2014; 20(18): 5331-5344
Published online May 14, 2014. doi: 10.3748/wjg.v20.i18.5331
Liver transplantation for malignancy: Current treatment strategies and future perspectives
Christina Hackl, Hans J Schlitt, Gabriele I Kirchner, Birgit Knoppke, Martin Loss
Christina Hackl, Hans J Schlitt, Martin Loss, Department of Surgery, University Hospital Regensburg, 93053 Regensburg, Germany
Gabriele I Kirchner, Department of Internal Medicine I, University Hospital Regensburg, 93053 Regensburg, Germany
Birgit Knoppke, Department of Pediatrics and Juvenile Medicine, University Hospital Regensburg, 93053 Regensburg, Germany
Author contributions: Hackl C contributed to conception and design, acquisition of data, drafting the article, critical revision for important intellectual content, final approval of the version to be published; Schlitt HJ contributed to conception and design, critical revision for important intellectual content, final approval of the version to be published; Kirchner GI contributed to critical revision for important intellectual content, final approval of the version to be published; Knoppke B contributed to critical revision for important intellectual content, final approval of the version to be published; and Loss M contributed to conception and design, drafting the article, critical revision for important intellectual content, final approval of the version to be published.
Correspondence to: Martin Loss, MD, Department of Surgery, University Hospital Regensburg, Franz Josef Strauss Allee 11, 93053 Regensburg, Germany. Martin.Loss@ukr.de
Telephone: +49-941-9446801 Fax: +49-941-9446802
Received: October 14, 2013
Revised: December 31, 2013
Accepted: February 26, 2014
Published online: May 14, 2014

Abstract

In 1967, Starzl et al performed the first successful liver transplantation for a patient diagnosed with hepatoblastoma. In the following, liver transplantation was considered ideal for complete tumor resection and potential cure from primary hepatic malignancies. Several reports of liver transplantation for primary and metastatic liver cancer however showed disappointing results and the strategy was soon dismissed. In 1996, Mazzaferro et al introduced the Milan criteria, offering liver transplantation to patients diagnosed with limited hepatocellular carcinoma. Since then, liver transplantation for malignant disease is an ongoing subject of preclinical and clinical research. In this context, several aspects must be considered: (1) Given the shortage of deceased-donor organs, long-term overall and disease free survival should be comparable with results obtained in patients transplanted for non-malignant disease; (2) In this regard, living-donor liver transplantation may in selected patients help to solve the ethical dilemma of optimal individual patient treatment vs organ allocation justice; and (3) Ongoing research focusing on perioperative therapy and anti-proliferative immunosuppressive regimens may further reduce tumor recurrence in patients transplanted for malignant disease and thus improve overall survival. The present review gives an overview of current indications and future perspectives of liver transplantation for malignant disease.

Key Words: Hepatocellular, Fibrolamellar, Carcinoma, Cholangiocellular, Hepatoblastoma, Liver metastases

Core tip: Liver transplantation for malignancy is a medical and ethical challenge with regard to oncologic outcome and allocation justice. Childhood hepatoblastoma, epithelioid hemangioendothelioma, limited hepatocellular carcinoma and fibrolamellar carcinoma are proven indications for liver transplantation. Recent clinical trials have suggested cholangiocellular adenocarcinoma and hepatic metastases originating from neuroendocrine tumors as new indications in selected patients. Ongoing research may further widen indications for liver transplantation in malignant disease and therefore also complicate organ allocation. Living-donor liver transplantation may offer a solution for selected patients.



INTRODUCTION

Liver transplantation (LT) is the only curative treatment option for patients with irrevocable acute or chronic liver failure and, in the last four decades, has developed from an experimental approach with very high mortality to an almost routine procedure with good short and long-term survival rates. During the last 15 years, survival rates world-wide are relatively stable with an overall survival (OS) of > 80% in the first year and > 70% at 5 years[1,2]. However, approximately 10% of patients listed for LT die on the waiting list[3] and many potential candidates, including patients diagnosed with primary or metastatic liver cancer, are not listed due to shortage of deceased-donor organs. While liver cirrhosis caused by chronic viral hepatitis and alcohol abuse are the two major causes for end-stage liver disease, most malignant diseases remain contraindications for LT.

Timing is crucial for the success of LT. On the one hand, best results are achieved if the patient is in a good general condition. On the other hand, decompensated and sickest patients most urgently need transplantation - but have the worst outcome. Due to shortage of deceased-donor organs, different allocation solutions are intensively discussed and permanently adapted. A model for the sickest first policy, the Model of End Stage Liver Disease (MELD), was implemented in the allocation procedure within the UNOS in 2002 and within the Eurotransplant network in 2007 (Patient based allocation). It is calculated of serum creatinine, international normalized ratio (INR) and bilirubin. The MELD was originally developed to predict 3-mo survival after transjugular intrahepatic portosystemic shunt placement[4,5]. Since implementation of the MELD system, the waiting list mortality for LT has declined. However, patients with very high laboratory MELD scores (> 35) are normally ICU bound, on dialysis and often require vasopressor support and artificial ventilation. Priorization of these patients led to a deterioration of the OS rates after LT since introduction of the MELD score for LT allocation in some countries like Germany[6]. In contrast, patients diagnosed with primary hepatic malignancy or hepatic metastases normally present in good clinical condition with low MELD score and exception MELD scoring is needed to enable transplantation before excessive tumor progress. Center based allocation is in use especially in countries with few transplant centers, e.g., in Australia, United Kingdom, and Austria. Moreover, it is used in parallel to the MELD system for extended criteria donor organs. The advantage of the center-based allocation is that the physicians can match the organ to the patient, which also enables allocation to recipients with malignancies.

In many East-Asian countries, deceased-donor liver donation (DDLT) is very rare due to religious and political reasons. This has led to sound establishment of living-donor liver transplantation (LDLT)[7-9] and might serve as an example for Western countries to reduce donor organ shortage.

SHORT HISTORY OF LIVER TRANSPLANTATION

The pioneer of human orthotopic LT, Thomas E. Starzl, learned about experimental auxiliary liver transplant models in dogs while attending a lecture by C. Stuart Welch in 1957[10]. After discussing and refining these canine models, Starzl was the first to attempt an orthotopic liver transplant into a 3 years old human recipient suffering from biliary atresia in 1963[11]. The patient did not survive the operation. After several equally unsuccessful attempts, Starzl et al[12] succeeded in performing an orthotopic liver transplant in a patient diagnosed with hepatoblastoma in 1967. LT for malignancy thus became the first successful LT in humans. The patient survived for 18 mo before dying from metastatic disease. During the subsequent years, major breakthroughs such as the expansion of the organ donor pool by introduction of the brain death criteria in 1968[13], refined surgical techniques and especially ongoing research in immunology leading to the introduction of immunosuppressive medication such as cyclosporine in 1979[14,15] lead to significant increase in LT. In 1983, the NIH declared that LT was a valid therapy for end-stage liver disease[16] and, a few years later, the United Network for Organ Sharing (UNOS) was founded[17]. Already in 1967, Eurotransplant International Foundation (ET) had been founded in Leiden, The Netherlands. In 1988, Rudolph Pichlmayr was the first to perform a split LT, offering one liver to two recipients[18].

INDICATIONS FOR LIVER TRANSPLANTATION

Indications for LT are manifold and can be classified into end-stage liver disease, acute liver failure and certain benign and malignant liver tumors. LT should be considered for any patient in whom anticipated OS exceeds life expectancy of the underlying disease or where significant increase in quality of life can be achieved. These criteria may also be valid for many patients diagnosed with primary liver tumors or hepatic metastases. However, LT for malignant disease is a medical and ethical challenge with regard to long-term oncologic outcome under immunosuppressive therapy and with regard to allocation justice due to organ shortage. Ongoing improvements in multimodality cancer therapy may in future widen indications for LT in malignant disease. Table 1 gives an overview of current indications for LT in malignancy within the UNOS and ET network.

Table 1 Indications and contraindications for liver transplantation in malignancy.
Standard indications
HCC in cirrhosis within Milan criteria
FLC
Hepatoblastoma (pediatric patients)
Epithelioid hemangioendothelioma
Investigational indications
HCC in cirrhosis exceeding Milan criteria
HCC without cirrhosis
CCA
Neuroendocrine liver metastases
Contraindications
HCC with extrahepatic disease or macro-invasion into portal vein
Hepatoblastoma with uncontrolled extrahepatic disease
Malignancies other than the indications mentioned
Cancer Survivors with complete remission < 2-5 yr[153]
LIVING-DONOR LIVER TRANSPLANTATION

Living-donor liver transplantation (LDLT) was successfully introduced in 1988 and 1989 respectively in the adult-to-pediatric and adult-to-adult setting[19]. In most East-Asian countries, LDLT is an established procedure and the main form of LT due to scarcity of deceased donor organs[7]. In western countries and especially in the UNOS area, use of living-donor organs for LT is less frequent and within UNOS even declining to currently < 10% of LT, although retrospective analyses have shown favorable or equal results as compared to DDLT[20-28]. The advantage of LDLT is the use of an optimal healthy donor, minimal ischemic time, elective surgery and timing of transplantation due to the recipients’ need, which is particularly relevant for patients diagnosed with malignant disease. LDLT can also enable LT for patients not qualifying for deceased-donor LT according to allocation rules as well as early LT before the tumor exceeds transplantability. However, living donation is not without risk for the healthy donor and LDLT is surgically more demanding than whole organ transplantation. For the donor, major complications (exceeding Clavien grade II) of up to 44% after right-lobe LDLT and a mortality risk of up to 0.8% have been described[29-31]. Increasing the use of left-lobe liver donations also for adult recipients may here offer a solution[30]. A careful risk to benefit evaluation for the donor and the recipient must be performed in a multidisciplinary team for each individual case.

IMMUNOSUPPRESSION

A highly relevant subject of translational research is post-transplant immunosuppression. In the early post-transplant phase, immunosuppressive therapy consists of complex combinations of drugs and needs to be adapted for each patient individually. Components are steroids, anti-lymphocyte antibodies, calcineurin-inhibitors and inhibitors of B-/and T-cell proliferation[32]. Steroids are the back-bone of all immunosuppressive regimens. They inhibit T-cell activation and block IL-1 and IL-2 synthesis. Steroids are given already before reperfusion of the transplanted organ intra-operatively and are continued in high doses during the early postoperative phase, followed by dose reduction schemes. In many patients, steroids can be tapered six months after transplantation[33].

The chimeric monoclonal T-cell IL2-receptor antibody basiliximab is given on day 0 and day 4 after liver transplant for induction therapy. Mycophenolate mofetil (MMF), a reversible inhibitor of inosine monophosphate dehydrogenase in purine synthesis, reduces proliferation of B- and T-cells and is well tolerated in LT patients[34]. Calcineurin-inhibitors such as cyclosporine inhibit T-cell production and excretion of IL-2. In cyclosporine A-based regimens, lowest-possible target levels have been linked to reduced tumor recurrence[35,36]. mTor-inhibitors such as sirolimus and everolimus also inhibit the proliferation of B- and T-cells. In contrast to calcineurin-inhibitors, mTor-inhibitors show no renal toxicity[37]. In LT for malignant disease, m-TOR inhibitors are highly promising immunosuppressive drugs, as they also block angiogenesis and tumor cell proliferation[38,39] and lower the risk of cancer recurrence[40].

Future immunosuppressive strategies in LT have to imply 3 main goals: (1) reduction of side effects like renal insufficiency; (2) reduction of cancer recurrence and de novo cancer after transplantation (particularly in LT for malignant disease); and (3) induction of tolerance. Studies are ongoing which try to induce tolerance by either stem cell therapy[41-43] or by transfusion of regulating cells in the setting of living donation (http://www.onestudy.org).

LIVER TRANSPLANTATION FOR PRIMARY MALIGNANCIES
Hepatocellular carcinoma

Hepatocellular carcinoma presents the sixth most common malignancy, and the third leading cause of cancer-related deaths world-wide[44]. Incidences vary from 38 per 100000 in male Chinese (14 per 100000 in female Chinese) to < 5 per 100000 in Northern Europe and North America[44]. Main risk factors for Hepatocellular carcinoma (HCC) are liver cirrhosis in the context of chronic HBV or HCV infection. Furthermore, alcohol-induced cirrhosis, aflatoxin intake, diabetes, obesity and hemochromatosis have been associated with a higher risk for developing HCC[45-48]. R0 resection combined with cure from the underlying liver pathology can only be achieved by LT. Disappointingly, first results of LT in HCC had shown a high perioperative mortality, 80% tumor recurrence and 5-year OS of 15.2%[49]. However, in 1991, Iwatsuki et al[50] could show that in the context of cirrhosis, long-term survival after LT for HCC was significantly higher than after liver resection with not significantly different tumor recurrence rates (50% and 43% after resection and LT, respectively). Retrospective analysis of patients where incidental, small HCC were found in the explanted liver after LT for cirrhosis showed no significant difference in OS compared to recipients transplanted for cirrhosis without incidentalomas[51]. In 1996, a landmark paper by Mazzaferro and colleagues established LT as standard indication for HCC within the “Milan criteria”, i.e., limited HCC (1 lesion ≤ 5 cm, or 2 to 3 lesions each ≤ 3 cm), no macro-vascular invasion and no regional nodal or distant metastasis[52]. Patients who, after retrospective pathologic review, met these criteria, showed a 4-year OS of 85%. In contrast, patients, in which HCC size, after retrospective pathologic review, exceeded these criteria, had a 4-year OS of 50%[52]. In the following, many retrospective analyses have confirmed these results[53] and a 2012 meta-analysis of 1763 patients undergoing liver resection vs LT for HCC within the Milan criteria confirmed a survival advantage for LT (5-year OS 63% vs 53%, OR = 0.581, 95%CI: 0.359-0.939, P = 0.027)[54].

Patients diagnosed with HCC often show sufficient liver function and thus, their urgency for LT is not adequately represented in their MELD scores. Therefore, cirrhotic HCC patients within the UNOS and ET network receive exception MELD (eMELD) scoring when diagnosed as American Liver Tumor Study Group (ALTSG) stage II HCC (i.e., single HCC 2-5 cm or 2-3 lesions < 3 cm) for UNOS patients and within Milan criteria for ET patients. The eMELD given is equivalent to a 15% probability of death within 3 mo and, at present, is 22. Subsequently, the eMELD is increased every 3 mo by the number of points equivalent to a 10% increase in mortality until transplantation or drop-out of Milan criteria. Continued documentation to prove that patients are still within the Milan criteria must be made by abdominal CT or MRI scanning every 3 mo[55]. Therefore, surgical resection and therapeutic interventions to control HCC progress during the waiting period (= “bridging”) are a focus of ongoing clinical research[56]. Bridging can be achieved by local interventional measures such as radiofrequency ablation (RFA), transarterial chemoembolization (TACE), percutaneous ethanol injection (PEI), selective internal radiation therapy (SIRT) and irreversible electroporation (IRE) or surgical resection[57-64]. Bridging has shown to reduce drop-out rate of HCC patients listed for LT by 10%-20%[65-67]. Furthermore, good response after interventional bridging has been described as positive predictive factor for improved outcome after LT[68-70].

LT for patients exceeding Milan criteria is controversially discussed. In 2001, Yao[56] showed comparable long-term outcome for LT in patients exceeding Milan criteria, and defined the “UCSF-criteria” as single lesion < 6.5 cm or up to 3 lesion with a total diameter of < 8 cm, the largest nodule being ≤ 4.5 cm in diameter[51]. In Australia and New Zealand, liver allocation for HCC is performed according to the UCSF criteria. In 2012, an international European-North American consensus agreed upon restriction of LT for HCC to patients meeting Milan criteria[71]. Listing of patients exceeding Milan criteria and/or neoadjuvant interventional downstaging of HCC patients to meet Milan criteria is recommended as individual center specific regulation within UNOS and limited to randomized clinical trials within the Eurotransplant network[67].

LDLT can offer a treatment option for selected HCC patients to minimize waiting time[22]. Due to very limited access to deceased-donor organs, LDLT is an established procedure and the main form of LT in most East-Asian countries[7]. In contrast, within the UNOS, only 5% of all LT are LDLT although retrospective analyses have shown favorable or equal results as compared to DDLT[20-25]. Furthermore, LDLT can enable LT also for patients exceeding Milan criteria. In 2012, an international European-North American consensus stated that LDLT is an acceptable procedure for patients with expected 5-year OS similar to DDLT[67]. Based on a data-collection of > 1200 HCC patients transplanted outside the Milan criteria, the “Metroticket”-calculator has been developed to predict survival of patients with HCC listed for LT[72]. Based on these data, individual evaluation of the potential risks and benefits has to be carefully discussed with each potential donor and recipient of LDLT.

Ongoing research in LT for HCC is focusing on mTor-based immunosuppressive regimens. In a first meta-analysis, the mTor-inhibitor sirolimus significantly decreased tumor recurrence in LT for HCC (OR = 0.30, 95%CI: 0.16-0.55)[73]. At present, a first randomized phase 3 clinical trial investigates the role of mTor-inhibition in LT for HCC (http://www.clinicaltrials.gov: NCT00355862)[37].

Fibrolamellar carcinoma

Fibrolamellar carcinoma is a very rare primary hepatic malignancy with an incidence of 0.02 per 100000[74]. In contrast to HCC, it mostly occurs in young adults (median age at diagnosis: 33 years) with no underlying liver pathology and no known risk factors. Overall survival in fibrolamellar carcinoma (FLC) patients is 32% at 5 years[74]. Surgical resection is the standard therapeutic approach for FLC and 5-year OS rates of 45% to 80% have been described[75-77]. In unresectable cases, LT has been described with acceptable 1- and 5-year OS rates of 90% and 50%, respectively[76,78]. Other than HCC patients, FLC patients listed for LT are not prioritized within the MELD score. Therefore, LDLT should be considered in unresectable FLC patients. For this decision, however, the high rate of early lymph node metastasis of this tumor - which may be a cause for early recurrence after LT, has to be considered.

Cholangiocellular adenocarcinoma

Cholangiocellular adenocarcinoma, although being the second most common primary hepatic malignancy, is a rare tumor with an incidence of < 2 per 100000 in the Western World. However, higher incidences have been reported in several East-Asian countries[79]. Risk factors associated with cholangiocellular adenocarcinoma (CCA) are primary sclerosing cholangitis, ulcerative colitis, choledochus cysts, hepatic tremadodes, hepatolithiasis and HCV[79]. In contrast to HCC, CCA originates in the bile duct epithelium and can be defined as intrahepatic, perihilar, or distal CCA[80]. If untreated, the 5-year OS of CCA is < 10%. Surgical resection, which is feasible in 70%-75% of CCA patients, results in a 5-year OS of < 50%[81-83]. For lymph node negative patients, long-term survival rates of up to 67% after R0 resection have been described[81-83]. A nomogram to predict long-term OS after CCA resection, based on retrospective analysis of 367 patients undergoing partial hepatectomy for intrahepatic CCA and using the parameters CEA, CA19-9, vascular invasion, lymph node metastasis, local metastasis, number of tumor nodules and diameter of the tumor, has been published by Wang et al[84].

First results of LT in CCA have shown a high perioperative mortality, 100% tumor recurrence and a 1-year OS of 20%[85]. A European transplantation registry analysis of 187 patients after LT for CCA showed a 5-year OS of 29% and a > 40% rate of recurrence[85,86]. CCA was thus not considered an indication for LT. By establishing a strict selection protocol and a neoadjuvant chemoradiotherapy regime, combined with staging laparotomy to exclude metastatic disease, the Mayo Clinic has in 2005 re-established CCA as investigational indication for hilar, lymph-node negative CCA in PSC patients[87]. In this landmark publication, 1-/3-/5-year OS rates after LT were 92%, 82%, and 82% vs 82%, 48%, and 21% in patients undergoing liver resection. Furthermore, recurrence rate after LT was significantly lower than after liver resection (13% vs 27%)[87]. A weakness of this study was the high rate (7 of 38 transplanted patients) of absent histologic CCA confirmation prior to LT combined with negative histology in hepatectomy specimen after LT. A consecutive intention-to-treat analysis, however, showed 1-/3-/5-year OS rates of respectively 82%, 63%, and 55% after LT for CCA[88]. In subsequent years, several analyses have confirmed these results for selected patients and in 2012, a first meta-analysis of 605 patients undergoing LT for CCA during 1995-2009 has shown pooled 1-/3-/5-year OS rates of 75%, 42% and 39%[89]. Importantly, in patients transplanted after neoadjuvant therapy, 5-year OS was 65% and is thus comparable to survival rates of LT for HCC within the Milan criteria.

Within the UNOS, individual patients diagnosed with unresectable hilar CCA can be listed for LT by individual transplant centers[90]. For approval of exception MELD scoring for these patients, transplant centers need to submit a written application to the UNOS transplantation committee. Patients potentially qualifying for LT must have a tumor of < 3 cm in abdominal CT, ultrasound or MRI. Transperitoneal biopsy should not be performed to avoid tumor spread. A neoadjuvant therapy protocol must be completed[91], followed by operative abdominal staging to exclude regional hepatic lymph node metastases, intrahepatic metastases, and/or extrahepatic disease. Thoracic metastases must be excluded by chest CT. UNOS can then grant exception MELD scoring of 22, increasing every 3 mo by the number of points equivalent to a 10% increase in mortality until LT or drop-out. Chest and abdominal CT restaging to prove listing criteria must then be performed every 3 mo[90].

Within the ET network, CCA is generally not regarded as indication for LT outside clinical trials. In Italy, a 2010 consensus statement has agreed upon performing LT for CCA in experimental settings[92]. However, an Italian clinical trial to validate the Mayo Clinic results is underway (http://http://http://www.clinicaltrials.goc NCT01549795). Also in the United States, a clinical trial to validate the Mayo Clinic results is performed (http://http://http://www.clinicaltrials.goc NCT00301379) and results are expected in 2015. At the Mayo Clinic, a pilot phase 1 clinical trial is testing application of sirolimus, gemcitabine and cisplatin for patients at high risk of CCA recurrence after LT (http://http://http://www.clinicaltrials.goc NCT01888302) and results are expected in 2014.

Since DDLT for CCA remains investigational and, in many countries, is not indicated, LDLT may offer a treatment option for highly selected CCA patients. First clinical results of LDLT for CCA have shown results comparable to DDLT[93-95]. Further research is needed to identify prognostic factors for transplant candidate selection.

Hepatic epithelioid hemangioendothelioma

Epithelioid hemangioendothelioma was first described and characterized as soft tissue low-grade malignant tumor in 1982[96]. Clinicopathologic characteristics of hepatic epithelioid hemangioendothelioma (HEHE) were defined by Ishak and colleagues[97] and a first series of LT for this malignancy was published in 1988[98].

HEHE shows an incidence of one per million[99] and diagnosis often is challenging. Clinical presentation is unspecific with abdominal pain, hepatomegaly, and fatigue[100,101] and clinical course varies between almost benign behavior like hemangioma to rapid progress like angiosarcoma[102]. Histologic characteristics combined with immunohistochemical diagnostic markers (factor-VIII related antigen, CD31, CD34, cytokeratin, podoplanin), together with ultrasound/CT/MR imaging are needed to confirm diagnosis. Although CEA and CA19-9 have been reported to be elevated in some patients with HEHE[101,103], there are no confirmed tumor markers identified for HEHE so far[102]. No clinical, radiological or histological markers exist to individually predict the natural course of HEHE. Although yearlong stable disease has been described, 5-year survival rates of untreated patients have been shown to be 5%[102].

The majority of patients diagnosed with HEHE show extensive, multifocal intrahepatic disease at time of diagnosis and up to 37% of patients present with synchronous extrahepatic metastases[102]. For patients diagnosed with localized hepatic disease, liver resection can result in 5-year OS rates of 75%[102]. However, reports of major hepatic resection for extended intrahepatic disease show contradictive results: On the one hand, long-term disease control[102] with successful rescue LT after HEHE recurrence[104] has been described; on the other hand, aggressive tumor regrowth after resection[105], potentially triggered by pro-angiogenic hepatotrophic signaling after surgery, can occur. In a Mayo Clinic analysis of 30 HEHE patients treated between 1984 and 2007, no significant difference in long-term OS and disease-free survival (DFS) was seen comparing liver resection vs LT for resectable HEHE[106]. Furthermore, the clinicopathological factors tumor size ≤ 10 cm, ≤ 10 tumor nodules and nodular disease in ≤ 4 hepatic segments were identified as predictors for prolonged OS and LT was suggested for patients with unresectable disease and favorable predictors.

Multiple reports have shown that the presence of extrahepatic disease is no obligatory contraindication to perform LT for HEHE[98,104,106,107]. Thus, LT remains the only potentially curative approach for unresectable HEHE with or without extrahepatic tumor manifestation.

Table 2 gives an overview of original reports (including > 5 patients) and two reviews analyzing LT for HEHE, including synopsis of UNOS, European and Canadian databases[98,100,102,104,106-109]. With 5-year OS of up to 83% (even in the presence of extrahepatic disease) and 5-year DFS of 46%-82%, outcome of LT for HEHE is comparable with non-malignant indications for LT and LT should thus be offered to all patients with unresectable HEHE or resectable HEHE with unfavorable predictors.

Table 2 Liver transplantation for hepatic epithelioid hemangioendothelioma.
DatabaseAuthorYearYear of LTnAge of patientsFemaleMean fullow-upOverall survival in %
DFS in %
LDLTExtrahep.Recurrence
1 yr3 yr5 yr1 yr3 yr5 yr
MayoGrotz20101984-20071121-79 yr (mean 46.7 yr)77%42 mo917373644646NR18%NR
UNOSRodriguez20081987-20051100-70 yr (median 36 yr)68%24 mo806864NRNRNRn.t.NRNR
CanadaNudo20081991-20051118-52 yr (mean 38.7 yr)77%81 mo8282calc 828069690%36%45%
EuropeLerut20071989-2004594-65 yr (median 41 yr)57%79 mo93NR8390NR825%17%24%
ReviewMehrabi20061984-2006128mean 41.7 yr58%NR967754NRNRNR2%NRNR
PittsburghMadariaga19951976-19931728-5853%56 mo1008667886859NRNRNR
ReviewYokoyama19901980-19888NRNR25 mo887348NRNRNRNRNR50%
PittsburghMarino19881963-19871024-52.5 yr (median 29.5 yr)60%NRNRNRcalc 76NRNRNRNR50%30%
Hepatoblastoma

Hepatoblastoma, first described in 1954 by Debre and colleagues[110], is the most common primary hepatic malignancy in children and shows an incidence of one to two per million[111,112]. Increased incidence of hepatoblastoma (HEBLA) is seen in prematurely born infants and infants with a low birth weight, as well as in patients diagnosed with Beckwith-Widemann Syndrome, Glycogen storage diseases 1-4, trisomy 18 and familial adenomatous polyposis[113-117]. Definite diagnosis can mostly be made upon characteristic ultrasound/CT/MRI imaging and elevated AFP levels > 1000 ng/mL and biopsy is not recommended[118]. If resectable, 5-year OS rates of 80% can be reached with combined chemotherapeutic and surgical treatment[99]. However, the majority of patients present with unresectable disease at first diagnosis; only up to 40% of patients are diagnosed with resectable disease[111]. Due to a high sensitivity to perioperative chemotherapy (90%-95%), the European International Society of Pediatric Oncology (SIOPEL) recommends neoadjuvant chemotherapy to downstage HEBLA before resection or LT[119]. In contrast, many North American Centers prefer resection without prior chemotherapy in resectable patients[111]. For unresectable HEBLA, LT remains the only curative treatment option and long-term survival of 67%-93% after LT has been described. Presence of extrahepatic disease, if chemo-sensitive and potentially resectable, is no contraindication to perform LT for HEBLA[111].

Table 3 gives an overview of original reports and reviews analyzing LT for HEBLA, including synopsis of UNOS and European (SIOPEL) databases[120-131]. With long-term OS rates of 65%-87% (even in the presence of extrahepatic, chemo-responsive disease) and recurrence rates of less than 26% (data not shown), LT should be offered to all patients with unresectable HEBLA. In borderline-resectable HEBLA, LT should be considered since publications have shown long-term OS of 85%-90% in patients receiving primary LT for HEBLA compared to 25%-40% in rescue-transplantation for recurrent disease after prior liver resection[121,128].

Table 3 Liver transplantation for hepatoblastoma.
DatabaseAuthorYearYear of LTnAge of patients at LT% femaleMedian FUOverall survival in %
LDLT
1 yr3 yr5 yr
SIOPEL-3HRZsiros20101998-200431< 16 yr (median 21 mo)NR54 moNR75%NRNR
Chicago/TorontoBrowne20081990-20041418 mo-13 yr (mean 57 mo)3646 mo71% @ 46 moNR
LondonFaraj20081993-2007250.5-10 yr (median 2.5 yr)326.8 yr917828%
StanfordBeaunoyer20071988-2006150.3-9.7 yr (mean 2.6 yr)473.3 ± 3.5 yr8787870
SpainAvila2006116 mo-14 yr91918225%
UNOS reviewAustin20061987-20041352.9 ± 2.5 yr387969
TexasMejia20051995-200310mean 5.8 yr50Mean 10.8 yr70% @ last FU (mean 10.8 yr)20%
KyotoKasahara20051990-200414NRNRNR78.6NR65.5100%
SIOPEL-1Otte20041990-1994121.25-11.6 yr (median 3.8 yr)42117 moNRNR75NR
DallasMolmenti20021984-200096 mo-16 yr (mean 6.4 yr)44NRNR67%NR0%
FranceChardot20021998-1999410-60 mo (mean 17 mo)NRNR75% at last FU (13-24 mo)100%
BirminghamPimpalwar20021991-2000120.15-8.78 yr at diag. (median 1.32 yr)NRNRNR93%83%0
PittsburghReyes20001989-199812NRNRNR9292830
LIVER TRANSPLANTATION FOR HEPATIC METASTASES
Neuroendocrine liver metastases

Neuroendocrine carcinomas were first described in 1907 by Siegfried Oberndorfer, defining them as “benign carcinomas”[132]. In 1927, he revised his definition after discovering their potential for malignant growth and metastasis[132]. Neuroendocrine carcinomas have an incidence of ≤ 5 per 100000 and show a variable location (60% in the gastrointestinal tract and almost 30% in the pancreas; other locations: endocrine organs, lung, skin, liver, breast; partly in the context of inherited syndromes[133]), and a very variable natural course of the disease[134]. According to the World Health Organization, neuroendocrine tumors are classified by mitotic index and Ki67 labelling index as low grade G1 [mitotic index (MI) < 2 per 10 high-power fields (HPF), Ki67 positivity < 3%], intermediate grade G2 (MI 2-20 per 10 HPF, Ki67 positivity 3%-20%), or high grade G3 (MI > 20 per 10 HPF, Ki67 positivity > 20%)[134]. Neuroendocrine tumors can be symptomatic dependent on their hormonal activity, but the majority remains hormonally inactive and/or shows unspecific symptoms[135]. Diagnosis is made by CT and MRI scan, (endo)sonography, 18FDG/DOTATOC/DOTATATE-PET and Octreotide-Scintigraphy, potential serum tumor markers in the serum can be chromogranin A, 5-HIAA, NSE and p38[134]. Treatment strategies for neuroendocrine liver metastases (mNET) include antihormonal therapy, interferone and chemotherapeutic treatment, regional ablation and surgery[136,137]. Analyses of SEER databases have shown 5-year OS rates of 35% in G1 and G2 neuroendocrine tumors and of < 5% for G3 tumors. However, 5-year OS of > 50% have been described of selected G1 patients after combined medical-surgical therapy without LT[138].

Table 4 gives an overview of original reports and reviews LT for mNET with > 100 patients, including a synopsis of UNOS and European databases[139-142]. 5-year OS rates of 47%-58% have been reported. In the largest reports from UNOS (194 patients, 1988-2011) and European databases (213 patients, 1982-2009), 5-year OS was 49% and 52%, respectively. Importantly, patients receiving LT for mNET in these publications have previously undergone non-transplant medical and surgical therapy and, in the European database analysis, 5-year OS rates from first diagnosis of mNET were 73% (84% for patients diagnosed after 2000). In the UNOS database, the 5-year OS rates after LT were comparable to the 5-year OS rates of 4693 patients transplanted for HCC during the same period. Current NCCN guidelines define LT for mNET as an investigational procedure, and ongoing research is performed in order to define positive predictors for appropriate patient selection. A European Consensus states that “in patients suffering from life-threatening hormonal disturbances refractory to medical therapy or patients with non-functioning tumors with diffuse unresectable liver metastases refractory to all other available treatments, LT may be a possible therapy option. Minimal requirements for consideration of LT are the following criteria: mortality should be < 10%, absence of extrahepatic disease as determined by PET/CT, primary tumor removed prior to transplantation, well-differentiated NET (NET G1, G2). Patients less than 50 years old who are free of extrahepatic tumor and have low Ki67 are those who are most likely to benefit from LT. However, a long-term disease-free survival by transplantation will be an exceptional event even in this highly selected subgroup”[138]. Tumor recurrence after LT is described as 60% and ongoing research is performed to define further prognostic markers such as Ki67, p53 and E-cadherin immunohistochemistry, hepatomegaly, location of primary, age of patients, percentage of liver involvement and time of transplantation after resection of primary[139,142-146].

Table 4 Liver transplantation for hepatic metastases of neuroendocrine tumors: reports with > 100 patients.
DatabaseAuthorYearYear of LTnAge of patientsFemaleFollow-upOverall survival in %
DFS in %
LDLTRecurrence
1 yr3 yr5 yr1 yr3 yr5 yr
EuropeLeTreut20131982-2009213Mean 46 yr46%Mean 56 ± 49 mo8165526540306%53%
UNOSGedaly20111988-2008150Mean 45 yr44%Mean 36.8 mo816549NRNR327%NR
UNOSN'Guyen20111988-2011194Mean 45 yr46%NR806149NRNRNRNRNR
UNOSN‘Guyen20112002-2011110Mean 45 yr46%NR856558NRNRNRNRNR
FranceLeTreut20081989-200585Mean 46 yr46%Mean 46 ± 47 mo7259475637202%NR
ReviewLehnert19981981-1997103Median 48 yr50%Calculated 60Calculated 47Calculated 24NR40%
Colorectal cancer liver metastases

Although the majority of patients diagnosed with colorectal cancer (CRC) can undergo initially curative local resection, the leading cause of death from CRC is metastatic disease. The primary metastatic site for patients diagnosed with CRC is the liver: 60%-70% of metastatic recurrences in CRC patients occur in the liver and up to 35% of metastatic CRC patients have metastases only in this organ[147]. Up until now, colorectal liver metastases (CLM) are a contraindication for LT due to (1) allocation justice in the light of deceased-donor organ shortage and (2) high rates of tumor recurrence after transplantation[148,149]. However, in a Norwegian landmark paper, Hagness and colleagues performed LT for 21 patients diagnosed with unresectable CLM and reported estimated 1-, 3- and 5-year OS rates of respectively 95%, 68% and 60%[150], with good quality of life, monitored during the first year after transplantation[151]. Furthermore, equivalently to the Milan criteria, prognostic factors such as diameter of largest metastasis < 55 cm, time since CRC surgery > 2 years, CEA-level < 80 mcg/L, and stable disease or partial response after chemotherapy before LT were defined and may in future serve as criteria selecting patients eligible for LT in CLM[150]. Hagness and colleagues showed that 5-year OS rates exceeded reported OS after systemic chemotherapy alone and were comparable to OS rates after liver resection for resectable CLM. Furthermore, this is the first study showing 5-year OS rates after LT for CLM comparable to survival rates of patients needing repeat LT for non-malignant disease and only slightly minor to long-term survival rates after LT for benign indications[150]. An ongoing and controversially discussed clinical trial evaluates, for the first time, liver resection vs LT in resectable CLM (http://www.clinicaltrials.gov, NCT01479608). Furthermore, LT may be a therapeutic option for CLM survivors with secondary liver failure caused by aggressive therapy with liver resection and local chemotherapy[152].

CONCLUSION

Ongoing research in LT for primary hepatic malignancies and metastatic liver disease may in future further widen indications for LT in malignant disease. However, although LT may significantly increase quality of life and OS rates for many patients diagnosed with malignancies, the shortage of deceased-donor organs enforces strict allocation rules, rendering LT inaccessible for many cancer patients. Thus, the ethical dilemma of organ allocation will increase - comparable to mass casualty incidences, when individualized medicine is limited by the available resources for the greatest possible number of beneficiaries. Furthermore, patients diagnosed with malignant disease often present in better general condition and with better liver function compared to patients needing LT for non-malignant disease, and thus are not adequately represented by the MELD allocation system. New organ allocation rules must therefore be defined for individual malignancies.

LDLT can here offer a solution for selected patients and may on the one hand increase the organ donor pool, on the other hand enable LT for borderline indications and last but not least enable early LT before the tumor exceeds transplantability.

To increase evidence-based indications for LT, further clinical trials are needed for the (1) comparison of long-term oncologic and overall outcome of living- vs deceased-donor LT in malignant disease; (2) establishment of predictive criteria to select patients benefiting most from LT; (3) standardization of organ allocation rules outside the MELD-criteria for defined malignancies; (4) establishment of standard perioperative chemotherapeutic regimens combined with LT; and (5) improvement of long-term antiproliferative immunosuppressive therapy.

Footnotes

P- Reviewers: Hinz S, Kim DY, Qin JM, Ramsay M S- Editor: Ma YJ L- Editor: A E- Editor: Liu XM

References
1.  Kim WR, Stock PG, Smith JM, Heimbach JK, Skeans MA, Edwards EB, Harper AM, Snyder JJ, Israni AK, Kasiske BL. OPTN/SRTR 2011 Annual Data Report: liver. Am J Transplant. 2013;13 Suppl 1:73-102.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 124]  [Cited by in F6Publishing: 93]  [Article Influence: 15.5]  [Reference Citation Analysis (0)]
2.  Jones PD, Hayashi PH, Barritt S. Liver transplantation in 2013: challenges and controversies. Minerva Gastroenterol Dietol. 2013;59:117-131.  [PubMed]  [DOI]  [Cited in This Article: ]
3.  Kim WR, Therneau TM, Benson JT, Kremers WK, Rosen CB, Gores GJ, Dickson ER. Deaths on the liver transplant waiting list: an analysis of competing risks. Hepatology. 2006;43:345-351.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 103]  [Cited by in F6Publishing: 78]  [Article Influence: 6.9]  [Reference Citation Analysis (0)]
4.  Malinchoc M, Kamath PS, Gordon FD, Peine CJ, Rank J, ter Borg PC. A model to predict poor survival in patients undergoing transjugular intrahepatic portosystemic shunts. Hepatology. 2000;31:864-871.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 1747]  [Cited by in F6Publishing: 1246]  [Article Influence: 83.2]  [Reference Citation Analysis (0)]
5.  Said A, Williams J, Holden J, Remington P, Gangnon R, Musat A, Lucey MR. Model for end stage liver disease score predicts mortality across a broad spectrum of liver disease. J Hepatol. 2004;40:897-903.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 232]  [Cited by in F6Publishing: 175]  [Article Influence: 14.5]  [Reference Citation Analysis (0)]
6.  Weismüller TJ, Negm A, Becker T, Barg-Hock H, Klempnauer J, Manns MP, Strassburg CP. The introduction of MELD-based organ allocation impacts 3-month survival after liver transplantation by influencing pretransplant patient characteristics. Transpl Int. 2009;22:970-978.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 61]  [Cited by in F6Publishing: 46]  [Article Influence: 5.1]  [Reference Citation Analysis (0)]
7.  Lee SG, Moon DB. Living donor liver transplantation for hepatocellular carcinoma. Recent Results Cancer Res. 2013;190:165-179.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 7]  [Cited by in F6Publishing: 8]  [Article Influence: 0.9]  [Reference Citation Analysis (0)]
8.  Moon DB, Lee SG, Hwang S, Kim KH, Ahn CS, Ha TY, Song GW, Jung DH, Park GC, Namkoong JM. More than 300 consecutive living donor liver transplants a year at a single center. Transplant Proc. 2013;45:1942-1947.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 23]  [Cited by in F6Publishing: 14]  [Article Influence: 3.3]  [Reference Citation Analysis (0)]
9.  Song GW, Lee SG, Hwang S, Ahn CS, Moon DB, Kim KH, Ha TY, Jung DH, Park GC, Namgung JM. Successful experiences of ABO-incompatible adult living donor liver transplantation in a single institute: no immunological failure in 10 consecutive cases. Transplant Proc. 2013;45:272-275.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 22]  [Cited by in F6Publishing: 18]  [Article Influence: 2.8]  [Reference Citation Analysis (0)]
10.  Starzl TE. The long reach of liver transplantation. Nat Med. 2012;18:1489-1492.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 25]  [Cited by in F6Publishing: 13]  [Article Influence: 3.1]  [Reference Citation Analysis (0)]
11.  Starzl TE, Marchioro TL, Vonkaulla KN, Hermann G, Brittain RS, Waddell WR. Homotransplantation of the liver in humans. Surg Gynecol Obstet. 1963;117:659-676.  [PubMed]  [DOI]  [Cited in This Article: ]
12.  Starzl TE, Groth CG, Brettschneider L, Penn I, Fulginiti VA, Moon JB, Blanchard H, Martin AJ, Porter KA. Orthotopic homotransplantation of the human liver. Ann Surg. 1968;168:392-415.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 1]  [Article Influence: 0.0]  [Reference Citation Analysis (0)]
13.  Shapiro HA. Brain death and organ transplantation. J Forensic Med. 1968;15:89-90.  [PubMed]  [DOI]  [Cited in This Article: ]
14.  Starzl TE, Iwatsuki S, Klintmalm G, Schröter GP, Weil R, Koep LJ, Porter KA. Liver transplantation, 1980, with particular reference to cyclosporin-A. Transplant Proc. 1981;13:281-285.  [PubMed]  [DOI]  [Cited in This Article: ]
15.  Starzl TE, Klintmalm GB, Porter KA, Iwatsuki S, Schröter GP. Liver transplantation with use of cyclosporin a and prednisone. N Engl J Med. 1981;305:266-269.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 319]  [Cited by in F6Publishing: 61]  [Article Influence: 8.0]  [Reference Citation Analysis (0)]
16.  National Institutes of Health Consensus Development Conference Statement: liver transplantation--June 20-23, 1983 Hepatology. 1984;4:107S-110S.  [PubMed]  [DOI]  [Cited in This Article: ]
17.  National Organ Transplant Act: Public Law 98-507 US Statut Large. 1984;98:2339-2348.  [PubMed]  [DOI]  [Cited in This Article: ]
18.  Pichlmayr R, Ringe B, Gubernatis G, Hauss J, Bunzendahl H. [Transplantation of a donor liver to 2 recipients (splitting transplantation)--a new method in the further development of segmental liver transplantation]. Langenbecks Arch Chir. 1988;373:127-130.  [PubMed]  [DOI]  [Cited in This Article: ]
19.  Broelsch CE, Emond JC, Whitington PF, Thistlethwaite JR, Baker AL, Lichtor JL. Application of reduced-size liver transplants as split grafts, auxiliary orthotopic grafts, and living related segmental transplants. Ann Surg. 1990;212:368-375; discussion 375-377.  [PubMed]  [DOI]  [Cited in This Article: ]
20.  Bhangui P, Vibert E, Majno P, Salloum C, Andreani P, Zocrato J, Ichai P, Saliba F, Adam R, Castaing D. Intention-to-treat analysis of liver transplantation for hepatocellular carcinoma: living versus deceased donor transplantation. Hepatology. 2011;53:1570-1579.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 96]  [Cited by in F6Publishing: 80]  [Article Influence: 9.6]  [Reference Citation Analysis (0)]
21.  Gondolesi GE, Roayaie S, Muñoz L, Kim-Schluger L, Schiano T, Fishbein TM, Emre S, Miller CM, Schwartz ME. Adult living donor liver transplantation for patients with hepatocellular carcinoma: extending UNOS priority criteria. Ann Surg. 2004;239:142-149.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 162]  [Cited by in F6Publishing: 131]  [Article Influence: 9.5]  [Reference Citation Analysis (0)]
22.  Grant RC, Sandhu L, Dixon PR, Greig PD, Grant DR, McGilvray ID. Living vs. deceased donor liver transplantation for hepatocellular carcinoma: a systematic review and meta-analysis. Clin Transplant. 2013;27:140-147.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 54]  [Cited by in F6Publishing: 45]  [Article Influence: 6.0]  [Reference Citation Analysis (0)]
23.  Kaihara S, Kiuchi T, Ueda M, Oike F, Fujimoto Y, Ogawa K, Kozaki K, Tanaka K. Living-donor liver transplantation for hepatocellular carcinoma. Transplantation. 2003;75:S37-S40.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 129]  [Cited by in F6Publishing: 21]  [Article Influence: 7.2]  [Reference Citation Analysis (0)]
24.  Sandhu L, Sandroussi C, Guba M, Selzner M, Ghanekar A, Cattral MS, McGilvray ID, Levy G, Greig PD, Renner EL. Living donor liver transplantation versus deceased donor liver transplantation for hepatocellular carcinoma: comparable survival and recurrence. Liver Transpl. 2012;18:315-322.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 43]  [Cited by in F6Publishing: 43]  [Article Influence: 4.8]  [Reference Citation Analysis (0)]
25.  Todo S, Furukawa H, Japanese Study Group on Organ Transplantation. Living donor liver transplantation for adult patients with hepatocellular carcinoma: experience in Japan. Ann Surg. 2004;240:451-459; discussion 459-461.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 309]  [Cited by in F6Publishing: 238]  [Article Influence: 18.2]  [Reference Citation Analysis (0)]
26.  Saidi RF, Jabbour N, Li Y, Shah SA, Bozorgzadeh A. Is left lobe adult-to-adult living donor liver transplantation ready for widespread use? The US experience (1998-2010). HPB (Oxford). 2012;14:455-460.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 23]  [Cited by in F6Publishing: 16]  [Article Influence: 2.6]  [Reference Citation Analysis (0)]
27.  Saidi RF, Markmann JF, Jabbour N, Li Y, Shah SA, Cosimi AB, Bozorgzadeh A. The faltering solid organ donor pool in the United States (2001-2010). World J Surg. 2012;36:2909-2913.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 31]  [Cited by in F6Publishing: 18]  [Article Influence: 3.9]  [Reference Citation Analysis (0)]
28.  Muzaale AD, Dagher NN, Montgomery RA, Taranto SE, McBride MA, Segev DL. Estimates of early death, acute liver failure, and long-term mortality among live liver donors. Gastroenterology. 2012;142:273-280.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 79]  [Cited by in F6Publishing: 39]  [Article Influence: 7.9]  [Reference Citation Analysis (0)]
29.  Roll GR, Roberts JP. Left versus right lobe liver donation. Am J Transplant. 2014;14:251-252.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 4]  [Cited by in F6Publishing: 3]  [Article Influence: 0.5]  [Reference Citation Analysis (0)]
30.  Roll GR, Parekh JR, Parker WF, Siegler M, Pomfret EA, Ascher NL, Roberts JP. Left hepatectomy versus right hepatectomy for living donor liver transplantation: shifting the risk from the donor to the recipient. Liver Transpl. 2013;19:472-481.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 72]  [Cited by in F6Publishing: 41]  [Article Influence: 9.0]  [Reference Citation Analysis (0)]
31.  Ghobrial RM, Freise CE, Trotter JF, Tong L, Ojo AO, Fair JH, Fisher RA, Emond JC, Koffron AJ, Pruett TL. Donor morbidity after living donation for liver transplantation. Gastroenterology. 2008;135:468-476.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 290]  [Cited by in F6Publishing: 168]  [Article Influence: 22.3]  [Reference Citation Analysis (0)]
32.  Geissler EK, Schlitt HJ. Immunosuppression for liver transplantation. Gut. 2009;58:452-463.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 92]  [Cited by in F6Publishing: 44]  [Article Influence: 7.1]  [Reference Citation Analysis (0)]
33.  Sgourakis G, Radtke A, Fouzas I, Mylona S, Goumas K, Gockel I, Lang H, Karaliotas C. Corticosteroid-free immunosuppression in liver transplantation: a meta-analysis and meta-regression of outcomes. Transpl Int. 2009;22:892-905.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 72]  [Cited by in F6Publishing: 48]  [Article Influence: 6.0]  [Reference Citation Analysis (0)]
34.  Schlitt HJ, Jonas S, Ganten TM, Grannas G, Moench C, Rauchfuss F, Obed A, Tisone G, Pinna AD, Gerunda GE. Effects of mycophenolate mofetil introduction in liver transplant patients: results from an observational, non-interventional, multicenter study (LOBSTER). Clin Transplant. 2013;27:368-378.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 2]  [Cited by in F6Publishing: 3]  [Article Influence: 0.3]  [Reference Citation Analysis (0)]
35.  Vivarelli M, Cucchetti A, Piscaglia F, La Barba G, Bolondi L, Cavallari A, Pinna AD. Analysis of risk factors for tumor recurrence after liver transplantation for hepatocellular carcinoma: key role of immunosuppression. Liver Transpl. 2005;11:497-503.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 138]  [Cited by in F6Publishing: 110]  [Article Influence: 8.6]  [Reference Citation Analysis (0)]
36.  Farkas SA, Schnitzbauer AA, Kirchner G, Obed A, Banas B, Schlitt HJ. Calcineurin inhibitor minimization protocols in liver transplantation. Transpl Int. 2009;22:49-60.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 71]  [Cited by in F6Publishing: 59]  [Article Influence: 5.9]  [Reference Citation Analysis (0)]
37.  Schnitzbauer AA, Zuelke C, Graeb C, Rochon J, Bilbao I, Burra P, de Jong KP, Duvoux C, Kneteman NM, Adam R. A prospective randomised, open-labeled, trial comparing sirolimus-containing versus mTOR-inhibitor-free immunosuppression in patients undergoing liver transplantation for hepatocellular carcinoma. BMC Cancer. 2010;10:190.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 118]  [Cited by in F6Publishing: 86]  [Article Influence: 10.7]  [Reference Citation Analysis (0)]
38.  Guba M, von Breitenbuch P, Steinbauer M, Koehl G, Flegel S, Hornung M, Bruns CJ, Zuelke C, Farkas S, Anthuber M. Rapamycin inhibits primary and metastatic tumor growth by antiangiogenesis: involvement of vascular endothelial growth factor. Nat Med. 2002;8:128-135.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 1285]  [Cited by in F6Publishing: 814]  [Article Influence: 67.6]  [Reference Citation Analysis (0)]
39.  Shirouzu Y, Ryschich E, Salnikova O, Kerkadze V, Schmidt J, Engelmann G. Rapamycin inhibits proliferation and migration of hepatoma cells in vitro. J Surg Res. 2010;159:705-713.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 12]  [Cited by in F6Publishing: 6]  [Article Influence: 0.9]  [Reference Citation Analysis (0)]
40.  Salvadori M. Antineoplastic effects of mammalian target of rapamycine inhibitors. World J Transplant. 2012;2:74-83.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in CrossRef: 6]  [Cited by in F6Publishing: 6]  [Article Influence: 0.9]  [Reference Citation Analysis (0)]
41.  Dahlke MH, Hoogduijn M, Eggenhofer E, Popp FC, Renner P, Slowik P, Rosenauer A, Piso P, Geissler EK, Lange C. Toward MSC in solid organ transplantation: 2008 position paper of the MISOT study group. Transplantation. 2009;88:614-619.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 57]  [Cited by in F6Publishing: 23]  [Article Influence: 4.8]  [Reference Citation Analysis (0)]
42.  Dillmann J, Popp FC, Fillenberg B, Zeman F, Eggenhofer E, Farkas S, Scherer MN, Koller M, Geissler EK, Deans R. Treatment-emergent adverse events after infusion of adherent stem cells: the MiSOT-I score for solid organ transplantation. Trials. 2012;13:211.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 11]  [Cited by in F6Publishing: 11]  [Article Influence: 1.2]  [Reference Citation Analysis (0)]
43.  Popp FC, Renner P, Eggenhofer E, Slowik P, Geissler EK, Piso P, Schlitt HJ, Dahlke MH. Mesenchymal stem cells as immunomodulators after liver transplantation. Liver Transpl. 2009;15:1192-1198.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 44]  [Cited by in F6Publishing: 38]  [Article Influence: 3.7]  [Reference Citation Analysis (0)]
44.  Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin. 2005;55:74-108.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 12780]  [Cited by in F6Publishing: 8048]  [Article Influence: 798.8]  [Reference Citation Analysis (0)]
45.  Anthony PP. Hepatocellular carcinoma: an overview. Histopathology. 2001;39:109-118.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 91]  [Cited by in F6Publishing: 63]  [Article Influence: 4.6]  [Reference Citation Analysis (0)]
46.  Block TM, Mehta AS, Fimmel CJ, Jordan R. Molecular viral oncology of hepatocellular carcinoma. Oncogene. 2003;22:5093-5107.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 350]  [Cited by in F6Publishing: 281]  [Article Influence: 19.4]  [Reference Citation Analysis (0)]
47.  Gomaa AI, Khan SA, Toledano MB, Waked I, Taylor-Robinson SD. Hepatocellular carcinoma: epidemiology, risk factors and pathogenesis. World J Gastroenterol. 2008;14:4300-4308.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in CrossRef: 398]  [Cited by in F6Publishing: 295]  [Article Influence: 30.6]  [Reference Citation Analysis (0)]
48.  Montalto G, Cervello M, Giannitrapani L, Dantona F, Terranova A, Castagnetta LA. Epidemiology, risk factors, and natural history of hepatocellular carcinoma. Ann N Y Acad Sci. 2002;963:13-20.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 183]  [Cited by in F6Publishing: 153]  [Article Influence: 9.6]  [Reference Citation Analysis (0)]
49.  Ringe B, Pichlmayr R, Wittekind C, Tusch G. Surgical treatment of hepatocellular carcinoma: experience with liver resection and transplantation in 198 patients. World J Surg. 1991;15:270-285.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 417]  [Cited by in F6Publishing: 91]  [Article Influence: 13.9]  [Reference Citation Analysis (0)]
50.  Iwatsuki S, Starzl TE, Sheahan DG, Yokoyama I, Demetris AJ, Todo S, Tzakis AG, Van Thiel DH, Carr B, Selby R. Hepatic resection versus transplantation for hepatocellular carcinoma. Ann Surg. 1991;214:221-228; discussion 228-229.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 464]  [Cited by in F6Publishing: 368]  [Article Influence: 15.5]  [Reference Citation Analysis (0)]
51.  Yao FY, Ferrell L, Bass NM, Watson JJ, Bacchetti P, Venook A, Ascher NL, Roberts JP. Liver transplantation for hepatocellular carcinoma: expansion of the tumor size limits does not adversely impact survival. Hepatology. 2001;33:1394-1403.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 1444]  [Cited by in F6Publishing: 1119]  [Article Influence: 72.2]  [Reference Citation Analysis (0)]
52.  Mazzaferro V, Regalia E, Doci R, Andreola S, Pulvirenti A, Bozzetti F, Montalto F, Ammatuna M, Morabito A, Gennari L. Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med. 1996;334:693-699.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 4631]  [Cited by in F6Publishing: 1153]  [Article Influence: 185.2]  [Reference Citation Analysis (0)]
53.  Mazzaferro V, Bhoori S, Sposito C, Bongini M, Langer M, Miceli R, Mariani L. Milan criteria in liver transplantation for hepatocellular carcinoma: an evidence-based analysis of 15 years of experience. Liver Transpl. 2011;17 Suppl 2:S44-S57.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 320]  [Cited by in F6Publishing: 233]  [Article Influence: 35.6]  [Reference Citation Analysis (0)]
54.  Dhir M, Lyden ER, Smith LM, Are C. Comparison of outcomes of transplantation and resection in patients with early hepatocellular carcinoma: a meta-analysis. HPB (Oxford). 2012;14:635-645.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 60]  [Cited by in F6Publishing: 45]  [Article Influence: 6.7]  [Reference Citation Analysis (0)]
55.  Earl TM, Chapman WC. Transplantation for hepatocellular carcinoma: the North American experience. Recent Results Cancer Res. 2013;190:145-164.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 9]  [Cited by in F6Publishing: 10]  [Article Influence: 1.1]  [Reference Citation Analysis (0)]
56.  Yao FY. Liver transplantation for hepatocellular carcinoma: beyond the Milan criteria. Am J Transplant. 2008;8:1982-1989.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 132]  [Cited by in F6Publishing: 101]  [Article Influence: 10.2]  [Reference Citation Analysis (0)]
57.  Belghiti J, Cortes A, Abdalla EK, Régimbeau JM, Prakash K, Durand F, Sommacale D, Dondero F, Lesurtel M, Sauvanet A. Resection prior to liver transplantation for hepatocellular carcinoma. Ann Surg. 2003;238:885-892; discussion 892-893.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 313]  [Cited by in F6Publishing: 247]  [Article Influence: 17.4]  [Reference Citation Analysis (0)]
58.  Castroagudín JF, Delgado M, Villanueva A, Bustamante M, Martínez J, Otero E, Tomé S, Martínez SM, Segade FR, Conde R. Safety of percutaneous ethanol injection as neoadjuvant therapy for hepatocellular carcinoma in waiting list liver transplant candidates. Transplant Proc. 2005;37:3871-3873.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 13]  [Cited by in F6Publishing: 8]  [Article Influence: 0.9]  [Reference Citation Analysis (0)]
59.  Chua TC, Saxena A, Chu F, Morris DL. Hepatic resection for transplantable hepatocellular carcinoma for patients within Milan and UCSF criteria. Am J Clin Oncol. 2012;35:141-145.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 9]  [Cited by in F6Publishing: 3]  [Article Influence: 1.0]  [Reference Citation Analysis (0)]
60.  Facciuto ME, Singh MK, Rochon C, Sharma J, Gimenez C, Katta U, Moorthy CR, Bentley-Hibbert S, Rodriguez-Davalos M, Wolf DC. Stereotactic body radiation therapy in hepatocellular carcinoma and cirrhosis: evaluation of radiological and pathological response. J Surg Oncol. 2012;105:692-698.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 53]  [Cited by in F6Publishing: 34]  [Article Influence: 5.3]  [Reference Citation Analysis (0)]
61.  Lu DS, Yu NC, Raman SS, Lassman C, Tong MJ, Britten C, Durazo F, Saab S, Han S, Finn R. Percutaneous radiofrequency ablation of hepatocellular carcinoma as a bridge to liver transplantation. Hepatology. 2005;41:1130-1137.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 244]  [Cited by in F6Publishing: 193]  [Article Influence: 15.3]  [Reference Citation Analysis (0)]
62.  O'Connor JK, Trotter J, Davis GL, Dempster J, Klintmalm GB, Goldstein RM. Long-term outcomes of stereotactic body radiation therapy in the treatment of hepatocellular cancer as a bridge to transplantation. Liver Transpl. 2012;18:949-954.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 91]  [Cited by in F6Publishing: 63]  [Article Influence: 10.1]  [Reference Citation Analysis (0)]
63.  Pompili M, Mirante VG, Rondinara G, Fassati LR, Piscaglia F, Agnes S, Covino M, Ravaioli M, Fagiuoli S, Gasbarrini G. Percutaneous ablation procedures in cirrhotic patients with hepatocellular carcinoma submitted to liver transplantation: Assessment of efficacy at explant analysis and of safety for tumor recurrence. Liver Transpl. 2005;11:1117-1126.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 136]  [Cited by in F6Publishing: 108]  [Article Influence: 8.5]  [Reference Citation Analysis (0)]
64.  Poon RT, Fan ST, Lo CM, Liu CL, Wong J. Long-term survival and pattern of recurrence after resection of small hepatocellular carcinoma in patients with preserved liver function: implications for a strategy of salvage transplantation. Ann Surg. 2002;235:373-382.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 596]  [Cited by in F6Publishing: 496]  [Article Influence: 31.4]  [Reference Citation Analysis (0)]
65.  Majno P, Lencioni R, Mornex F, Girard N, Poon RT, Cherqui D. Is the treatment of hepatocellular carcinoma on the waiting list necessary? Liver Transpl. 2011;17 Suppl 2:S98-108.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 51]  [Cited by in F6Publishing: 34]  [Article Influence: 5.7]  [Reference Citation Analysis (0)]
66.  Yao FY, Bass NM, Nikolai B, Merriman R, Davern TJ, Kerlan R, Ascher NL, Roberts JP. A follow-up analysis of the pattern and predictors of dropout from the waiting list for liver transplantation in patients with hepatocellular carcinoma: implications for the current organ allocation policy. Liver Transpl. 2003;9:684-692.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 193]  [Cited by in F6Publishing: 151]  [Article Influence: 10.7]  [Reference Citation Analysis (0)]
67.  European Association For The Study Of The Liver, European Organisation For Research And Treatment Of Cancer. EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma. J Hepatol. 2012;56:908-943.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 3642]  [Cited by in F6Publishing: 2686]  [Article Influence: 404.7]  [Reference Citation Analysis (0)]
68.  Bharat A, Brown DB, Crippin JS, Gould JE, Lowell JA, Shenoy S, Desai NM, Chapman WC. Pre-liver transplantation locoregional adjuvant therapy for hepatocellular carcinoma as a strategy to improve longterm survival. J Am Coll Surg. 2006;203:411-420.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 92]  [Cited by in F6Publishing: 78]  [Article Influence: 6.1]  [Reference Citation Analysis (0)]
69.  Chan KM, Yu MC, Chou HS, Wu TJ, Lee CF, Lee WC. Significance of tumor necrosis for outcome of patients with hepatocellular carcinoma receiving locoregional therapy prior to liver transplantation. Ann Surg Oncol. 2011;18:2638-2646.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 24]  [Cited by in F6Publishing: 20]  [Article Influence: 2.4]  [Reference Citation Analysis (0)]
70.  Graziadei IW, Sandmueller H, Waldenberger P, Koenigsrainer A, Nachbaur K, Jaschke W, Margreiter R, Vogel W. Chemoembolization followed by liver transplantation for hepatocellular carcinoma impedes tumor progression while on the waiting list and leads to excellent outcome. Liver Transpl. 2003;9:557-563.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 328]  [Cited by in F6Publishing: 264]  [Article Influence: 18.2]  [Reference Citation Analysis (0)]
71.  Clavien PA, Lesurtel M, Bossuyt PM, Gores GJ, Langer B, Perrier A. Recommendations for liver transplantation for hepatocellular carcinoma: an international consensus conference report. Lancet Oncol. 2012;13:e11-e22.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 600]  [Cited by in F6Publishing: 193]  [Article Influence: 60.0]  [Reference Citation Analysis (0)]
72.  Mazzaferro V, Llovet JM, Miceli R, Bhoori S, Schiavo M, Mariani L, Camerini T, Roayaie S, Schwartz ME, Grazi GL. Predicting survival after liver transplantation in patients with hepatocellular carcinoma beyond the Milan criteria: a retrospective, exploratory analysis. Lancet Oncol. 2009;10:35-43.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 1089]  [Cited by in F6Publishing: 365]  [Article Influence: 83.8]  [Reference Citation Analysis (0)]
73.  Menon KV, Hakeem AR, Heaton ND. Meta-analysis: recurrence and survival following the use of sirolimus in liver transplantation for hepatocellular carcinoma. Aliment Pharmacol Ther. 2013;37:411-419.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 87]  [Cited by in F6Publishing: 67]  [Article Influence: 9.7]  [Reference Citation Analysis (0)]
74.  El-Serag HB, Davila JA. Is fibrolamellar carcinoma different from hepatocellular carcinoma? A US population-based study. Hepatology. 2004;39:798-803.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 179]  [Cited by in F6Publishing: 108]  [Article Influence: 10.5]  [Reference Citation Analysis (0)]
75.  Kakar S, Burgart LJ, Batts KP, Garcia J, Jain D, Ferrell LD. Clinicopathologic features and survival in fibrolamellar carcinoma: comparison with conventional hepatocellular carcinoma with and without cirrhosis. Mod Pathol. 2005;18:1417-1423.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 112]  [Cited by in F6Publishing: 75]  [Article Influence: 7.5]  [Reference Citation Analysis (0)]
76.  Pinna AD, Iwatsuki S, Lee RG, Todo S, Madariaga JR, Marsh JW, Casavilla A, Dvorchik I, Fung JJ, Starzl TE. Treatment of fibrolamellar hepatoma with subtotal hepatectomy or transplantation. Hepatology. 1997;26:877-883.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 116]  [Cited by in F6Publishing: 76]  [Article Influence: 4.8]  [Reference Citation Analysis (0)]
77.  Stipa F, Yoon SS, Liau KH, Fong Y, Jarnagin WR, D’Angelica M, Abou-Alfa G, Blumgart LH, DeMatteo RP. Outcome of patients with fibrolamellar hepatocellular carcinoma. Cancer. 2006;106:1331-1338.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 131]  [Cited by in F6Publishing: 78]  [Article Influence: 8.7]  [Reference Citation Analysis (0)]
78.  El-Gazzaz G, Wong W, El-Hadary MK, Gunson BK, Mirza DF, Mayer AD, Buckels JA, McMaster P. Outcome of liver resection and transplantation for fibrolamellar hepatocellular carcinoma. Transpl Int. 2000;13 Suppl 1:S406-S409.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 8]  [Cited by in F6Publishing: 13]  [Article Influence: 0.4]  [Reference Citation Analysis (0)]
79.  Bragazzi MC, Carpino G, Venere R, Semeraro R, Gentile R, Gaudio E, Alvaro , D . Cholangiocarcinoma: Epidemiology and risk factors. Transl. Gastrointest. Cancer. 2012;1:21-32.  [PubMed]  [DOI]  [Cited in This Article: ]
80.  Burke EC, Jarnagin WR, Hochwald SN, Pisters PW, Fong Y, Blumgart LH. Hilar Cholangiocarcinoma: patterns of spread, the importance of hepatic resection for curative operation, and a presurgical clinical staging system. Ann Surg. 1998;228:385-394.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 325]  [Cited by in F6Publishing: 233]  [Article Influence: 14.1]  [Reference Citation Analysis (0)]
81.  Choi SB, Kim KS, Choi JY, Park SW, Choi JS, Lee WJ, Chung JB. The prognosis and survival outcome of intrahepatic cholangiocarcinoma following surgical resection: association of lymph node metastasis and lymph node dissection with survival. Ann Surg Oncol. 2009;16:3048-3056.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 189]  [Cited by in F6Publishing: 144]  [Article Influence: 15.8]  [Reference Citation Analysis (0)]
82.  DeOliveira ML, Cunningham SC, Cameron JL, Kamangar F, Winter JM, Lillemoe KD, Choti MA, Yeo CJ, Schulick RD. Cholangiocarcinoma: thirty-one-year experience with 564 patients at a single institution. Ann Surg. 2007;245:755-762.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 777]  [Cited by in F6Publishing: 535]  [Article Influence: 55.5]  [Reference Citation Analysis (0)]
83.  Hemming AW, Reed AI, Fujita S, Foley DP, Howard RJ. Surgical management of hilar cholangiocarcinoma. Ann Surg. 2005;241:693-699; discussion 699-702.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 245]  [Cited by in F6Publishing: 185]  [Article Influence: 15.3]  [Reference Citation Analysis (0)]
84.  Wang Y, Li J, Xia Y, Gong R, Wang K, Yan Z, Wan X, Liu G, Wu D, Shi L. Prognostic nomogram for intrahepatic cholangiocarcinoma after partial hepatectomy. J Clin Oncol. 2013;31:1188-1195.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 478]  [Cited by in F6Publishing: 211]  [Article Influence: 59.8]  [Reference Citation Analysis (0)]
85.  Pichlmayr R, Weimann A, Oldhafer KJ, Schlitt HJ, Klempnauer J, Bornscheuer A, Chavan A, Schmoll E, Lang H, Tusch G. Role of liver transplantation in the treatment of unresectable liver cancer. World J Surg. 1995;19:807-813.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 117]  [Cited by in F6Publishing: 19]  [Article Influence: 4.5]  [Reference Citation Analysis (0)]
86.  Weimann A, Varnholt H, Schlitt HJ, Lang H, Flemming P, Hustedt C, Tusch G, Raab R. Retrospective analysis of prognostic factors after liver resection and transplantation for cholangiocellular carcinoma. Br J Surg. 2000;87:1182-1187.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 80]  [Cited by in F6Publishing: 58]  [Article Influence: 3.8]  [Reference Citation Analysis (0)]
87.  Rea DJ, Heimbach JK, Rosen CB, Haddock MG, Alberts SR, Kremers WK, Gores GJ, Nagorney DM. Liver transplantation with neoadjuvant chemoradiation is more effective than resection for hilar cholangiocarcinoma. Ann Surg. 2005;242:451-458; discussion 458-461.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 142]  [Cited by in F6Publishing: 165]  [Article Influence: 8.9]  [Reference Citation Analysis (0)]
88.  Rosen CB, Heimbach JK, Gores GJ. Surgery for cholangiocarcinoma: the role of liver transplantation. HPB (Oxford). 2008;10:186-189.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 88]  [Cited by in F6Publishing: 52]  [Article Influence: 8.0]  [Reference Citation Analysis (0)]
89.  Gu J, Bai J, Shi X, Zhou J, Qiu Y, Wu Y, Jiang C, Sun X, Xu F, Zhang Y. Efficacy and safety of liver transplantation in patients with cholangiocarcinoma: a systematic review and meta-analysis. Int J Cancer. 2012;130:2155-2163.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 17]  [Cited by in F6Publishing: 11]  [Article Influence: 1.9]  [Reference Citation Analysis (0)]
90.  Organ Procurement and Transplantation Network. Allocation of livers. Accessed 26 July 2013.  Available from: http://optn.transplant.hrsa.gov/PoliciesandBylaws2/policies/pdfs/policy_8.pdf.  [PubMed]  [DOI]  [Cited in This Article: ]
91.  Pandey D, Lee KH, Tan KC. The role of liver transplantation for hilar cholangiocarcinoma. Hepatobiliary Pancreat Dis Int. 2007;6:248-253.  [PubMed]  [DOI]  [Cited in This Article: ]
92.  Alvaro D, Cannizzaro R, Labianca R, Valvo F, Farinati F, Italian Society of Gastroenterology (SIGE), Italian Association of Hospital Gastroenterology (AIGO), Italian Association of Medical Oncology (AIOM), Italian Association of Oncological Radiotherapy (AIRO). Cholangiocarcinoma: A position paper by the Italian Society of Gastroenterology (SIGE), the Italian Association of Hospital Gastroenterology (AIGO), the Italian Association of Medical Oncology (AIOM) and the Italian Association of Oncological Radiotherapy (AIRO). Dig Liver Dis. 2010;42:831-838.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 23]  [Cited by in F6Publishing: 13]  [Article Influence: 2.1]  [Reference Citation Analysis (0)]
93.  Axelrod D, Koffron A, Kulik L, Al-Saden P, Mulcahy M, Baker T, Fryer J, Abecassis M. Living donor liver transplant for malignancy. Transplantation. 2005;79:363-366.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 22]  [Cited by in F6Publishing: 1]  [Article Influence: 1.4]  [Reference Citation Analysis (0)]
94.  Jonas S, Mittler J, Pascher A, Theruvath T, Thelen A, Klupp J, Langrehr JM, Neuhaus P. Extended indications in living-donor liver transplantation: bile duct cancer. Transplantation. 2005;80:S101-S104.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 26]  [Cited by in F6Publishing: 16]  [Article Influence: 1.7]  [Reference Citation Analysis (0)]
95.  Schüle S, Altendorf-Hofmann A, Uteß F, Rauchfuß F, Freesmeyer M, Knösel T, Dittmar Y, Settmacher U. Liver transplantation for hilar cholangiocarcinoma--a single-centre experience. Langenbecks Arch Surg. 2013;398:71-77.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 11]  [Cited by in F6Publishing: 14]  [Article Influence: 1.2]  [Reference Citation Analysis (0)]
96.  Weiss SW, Enzinger FM. Epithelioid hemangioendothelioma: a vascular tumor often mistaken for a carcinoma. Cancer. 1982;50:970-981.  [PubMed]  [DOI]  [Cited in This Article: ]  [Reference Citation Analysis (0)]
97.  Ishak KG, Sesterhenn IA, Goodman ZD, Rabin L, Stromeyer FW. Epithelioid hemangioendothelioma of the liver: a clinicopathologic and follow-up study of 32 cases. Hum Pathol. 1984;15:839-852.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 325]  [Cited by in F6Publishing: 51]  [Article Influence: 8.8]  [Reference Citation Analysis (0)]
98.  Marino IR, Todo S, Tzakis AG, Klintmalm G, Kelleher M, Iwatsuki S, Starzl TE, Esquivel CO. Treatment of hepatic epithelioid hemangioendothelioma with liver transplantation. Cancer. 1988;62:2079-2084.  [PubMed]  [DOI]  [Cited in This Article: ]
99.  Hertl M, Cosimi AB. Liver transplantation for malignancy. Oncologist. 2005;10:269-281.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 85]  [Cited by in F6Publishing: 65]  [Article Influence: 5.3]  [Reference Citation Analysis (0)]
100.  Rodriguez JA, Becker NS, O’Mahony CA, Goss JA, Aloia TA. Long-term outcomes following liver transplantation for hepatic hemangioendothelioma: the UNOS experience from 1987 to 2005. J Gastrointest Surg. 2008;12:110-116.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 74]  [Cited by in F6Publishing: 55]  [Article Influence: 5.3]  [Reference Citation Analysis (0)]
101.  Makhlouf HR, Ishak KG, Goodman ZD. Epithelioid hemangioendothelioma of the liver: a clinicopathologic study of 137 cases. Cancer. 1999;85:562-582.  [PubMed]  [DOI]  [Cited in This Article: ]  [Reference Citation Analysis (0)]
102.  Mehrabi A, Kashfi A, Fonouni H, Schemmer P, Schmied BM, Hallscheidt P, Schirmacher P, Weitz J, Friess H, Buchler MW. Primary malignant hepatic epithelioid hemangioendothelioma: a comprehensive review of the literature with emphasis on the surgical therapy. Cancer. 2006;107:2108-2121.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 272]  [Cited by in F6Publishing: 152]  [Article Influence: 18.1]  [Reference Citation Analysis (0)]
103.  Wang LR, Zhou JM, Zhao YM, He HW, Chai ZT, Wang M, Ji Y, Chen Y, Liu C, Sun HC. Clinical experience with primary hepatic epithelioid hemangioendothelioma: retrospective study of 33 patients. World J Surg. 2012;36:2677-2683.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 29]  [Cited by in F6Publishing: 19]  [Article Influence: 3.6]  [Reference Citation Analysis (0)]
104.  Lerut JP, Orlando G, Adam R, Schiavo M, Klempnauer J, Mirza D, Boleslawski E, Burroughs A, Sellés CF, Jaeck D. The place of liver transplantation in the treatment of hepatic epitheloid hemangioendothelioma: report of the European liver transplant registry. Ann Surg. 2007;246:949-957; discussion 957.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 112]  [Cited by in F6Publishing: 39]  [Article Influence: 8.6]  [Reference Citation Analysis (0)]
105.  Ben-Haim M, Roayaie S, Ye MQ, Thung SN, Emre S, Fishbein TA, Sheiner PM, Miller CM, Schwartz ME. Hepatic epithelioid hemangioendothelioma: resection or transplantation, which and when? Liver Transpl Surg. 1999;5:526-531.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 74]  [Cited by in F6Publishing: 50]  [Article Influence: 4.1]  [Reference Citation Analysis (0)]
106.  Grotz TE, Nagorney D, Donohue J, Que F, Kendrick M, Farnell M, Harmsen S, Mulligan D, Nguyen J, Rosen C. Hepatic epithelioid haemangioendothelioma: is transplantation the only treatment option? HPB (Oxford). 2010;12:546-553.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 58]  [Cited by in F6Publishing: 34]  [Article Influence: 5.3]  [Reference Citation Analysis (0)]
107.  Nudo CG, Yoshida EM, Bain VG, Marleau D, Wong P, Marotta PJ, Renner E, Watt KD, Deschênes M. Liver transplantation for hepatic epithelioid hemangioendothelioma: the Canadian multicentre experience. Can J Gastroenterol. 2008;22:821-824.  [PubMed]  [DOI]  [Cited in This Article: ]
108.  Madariaga JR, Marino IR, Karavias DD, Nalesnik MA, Doyle HR, Iwatsuki S, Fung JJ, Starzl TE. Long-term results after liver transplantation for primary hepatic epithelioid hemangioendothelioma. Ann Surg Oncol. 1995;2:483-487.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 84]  [Cited by in F6Publishing: 16]  [Article Influence: 3.4]  [Reference Citation Analysis (0)]
109.  Yokoyama I, Todo S, Iwatsuki S, Starzl TE. Liver transplantation in the treatment of primary liver cancer. Hepatogastroenterology. 1990;37:188-193.  [PubMed]  [DOI]  [Cited in This Article: ]
110.  Debre R, Mozziconacci P, Habib E, Habib R. [Hepatoblastoma: malignant tumor of the liver with embryonic cells]. Arch Fr Pediatr. 1954;11:1013-1034.  [PubMed]  [DOI]  [Cited in This Article: ]
111.  Grossman EJ, Millis JM. Liver transplantation for non-hepatocellular carcinoma malignancy: Indications, limitations, and analysis of the current literature. Liver Transpl. 2010;16:930-942.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 40]  [Cited by in F6Publishing: 26]  [Article Influence: 3.6]  [Reference Citation Analysis (0)]
112.  Meyers RL, Tiao GM, Dunn SP, Langham MR. Liver transplantation in the management of unresectable hepatoblastoma in children. Front Biosci (Elite Ed). 2012;4:1293-1302.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 31]  [Cited by in F6Publishing: 10]  [Article Influence: 3.4]  [Reference Citation Analysis (0)]
113.  Weksberg R, Shuman C, Smith AC. Beckwith-Wiedemann syndrome. Am J Med Genet C Semin Med Genet. 2005;137C:12-23.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 221]  [Cited by in F6Publishing: 106]  [Article Influence: 13.8]  [Reference Citation Analysis (0)]
114.  Siciliano M, De Candia E, Ballarin S, Vecchio FM, Servidei S, Annese R, Landolfi R, Rossi L. Hepatocellular carcinoma complicating liver cirrhosis in type IIIa glycogen storage disease. J Clin Gastroenterol. 2000;31:80-82.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 31]  [Cited by in F6Publishing: 16]  [Article Influence: 1.5]  [Reference Citation Analysis (0)]
115.  McLaughlin CC, Baptiste MS, Schymura MJ, Nasca PC, Zdeb MS. Maternal and infant birth characteristics and hepatoblastoma. Am J Epidemiol. 2006;163:818-828.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 86]  [Cited by in F6Publishing: 44]  [Article Influence: 5.7]  [Reference Citation Analysis (0)]
116.  Maruyama K, Ikeda H, Koizumi T. Hepatoblastoma associated with trisomy 18 syndrome: a case report and a review of the literature. Pediatr Int. 2001;43:302-305.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 30]  [Cited by in F6Publishing: 11]  [Article Influence: 1.5]  [Reference Citation Analysis (0)]
117.  Giardiello FM, Petersen GM, Brensinger JD, Luce MC, Cayouette MC, Bacon J, Booker SV, Hamilton SR. Hepatoblastoma and APC gene mutation in familial adenomatous polyposis. Gut. 1996;39:867-869.  [PubMed]  [DOI]  [Cited in This Article: ]
118.  Zimmermann A. The emerging family of hepatoblastoma tumours: from ontogenesis to oncogenesis. Eur J Cancer. 2005;41:1503-1514.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 82]  [Cited by in F6Publishing: 37]  [Article Influence: 5.1]  [Reference Citation Analysis (0)]
119.  Brown J, Perilongo G, Shafford E, Keeling J, Pritchard J, Brock P, Dicks-Mireaux C, Phillips A, Vos A, Plaschkes J. Pretreatment prognostic factors for children with hepatoblastoma-- results from the International Society of Paediatric Oncology (SIOP) study SIOPEL 1. Eur J Cancer. 2000;36:1418-1425.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 208]  [Cited by in F6Publishing: 31]  [Article Influence: 9.9]  [Reference Citation Analysis (0)]
120.  Zsíros J, Maibach R, Shafford E, Brugieres L, Brock P, Czauderna P, Roebuck D, Childs M, Zimmermann A, Laithier V. Successful treatment of childhood high-risk hepatoblastoma with dose-intensive multiagent chemotherapy and surgery: final results of the SIOPEL-3HR study. J Clin Oncol. 2010;28:2584-2590.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 199]  [Cited by in F6Publishing: 35]  [Article Influence: 18.1]  [Reference Citation Analysis (0)]
121.  Browne M, Sher D, Grant D, Deluca E, Alonso E, Whitington PF, Superina RA. Survival after liver transplantation for hepatoblastoma: a 2-center experience. J Pediatr Surg. 2008;43:1973-1981.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 54]  [Cited by in F6Publishing: 26]  [Article Influence: 4.5]  [Reference Citation Analysis (0)]
122.  Faraj W, Dar F, Marangoni G, Bartlett A, Melendez HV, Hadzic D, Dhawan A, Mieli-Vergani G, Rela M, Heaton N. Liver transplantation for hepatoblastoma. Liver Transpl. 2008;14:1614-1619.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 59]  [Cited by in F6Publishing: 25]  [Article Influence: 4.9]  [Reference Citation Analysis (0)]
123.  Beaunoyer M, Vanatta JM, Ogihara M, Strichartz D, Dahl G, Berquist WE, Castillo RO, Cox KL, Esquivel CO. Outcomes of transplantation in children with primary hepatic malignancy. Pediatr Transplant. 2007;11:655-660.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 60]  [Cited by in F6Publishing: 33]  [Article Influence: 4.3]  [Reference Citation Analysis (0)]
124.  Avila LF, Luis AL, Hernandez F, Garcia Miguel P, Jara P, Andres AM, Lopez Santamaría M, Tovar JA. Liver transplantation for malignant tumours in children. Eur J Pediatr Surg. 2006;16:411-414.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 26]  [Cited by in F6Publishing: 16]  [Article Influence: 1.9]  [Reference Citation Analysis (0)]
125.  Austin MT, Leys CM, Feurer ID, Lovvorn HN, O’Neill JA, Pinson CW, Pietsch JB. Liver transplantation for childhood hepatic malignancy: a review of the United Network for Organ Sharing (UNOS) database. J Pediatr Surg. 2006;41:182-186.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 102]  [Cited by in F6Publishing: 58]  [Article Influence: 6.8]  [Reference Citation Analysis (0)]
126.  Mejia A, Langnas AN, Shaw BW, Torres C, Sudan DL. Living and deceased donor liver transplantation for unresectable hepatoblastoma at a single center. Clin Transplant. 2005;19:721-725.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 12]  [Cited by in F6Publishing: 4]  [Article Influence: 0.8]  [Reference Citation Analysis (0)]
127.  Kasahara M, Ueda M, Haga H, Hiramatsu H, Kobayashi M, Adachi S, Sakamoto S, Oike F, Egawa H, Takada Y. Living-donor liver transplantation for hepatoblastoma. Am J Transplant. 2005;5:2229-2235.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 45]  [Cited by in F6Publishing: 20]  [Article Influence: 3.0]  [Reference Citation Analysis (0)]
128.  Otte JB, Pritchard J, Aronson DC, Brown J, Czauderna P, Maibach R, Perilongo G, Shafford E, Plaschkes J, International Society of Pediatric Oncology (SIOP). Liver transplantation for hepatoblastoma: results from the International Society of Pediatric Oncology (SIOP) study SIOPEL-1 and review of the world experience. Pediatr Blood Cancer. 2004;42:74-83.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 241]  [Cited by in F6Publishing: 104]  [Article Influence: 14.2]  [Reference Citation Analysis (0)]
129.  Molmenti EP, Wilkinson K, Molmenti H, Roden JS, Squires RH, Fasola CG, Tomlinson G, Nagata DE, D’Amico L, Lopez MJ. Treatment of unresectable hepatoblastoma with liver transplantation in the pediatric population. Am J Transplant. 2002;2:535-538.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 43]  [Cited by in F6Publishing: 18]  [Article Influence: 2.4]  [Reference Citation Analysis (0)]
130.  Chardot C, Saint Martin C, Gilles A, Brichard B, Janssen M, Sokal E, Clapuyt P, Lerut J, Reding R, Otte JB. Living-related liver transplantation and vena cava reconstruction after total hepatectomy including the vena cava for hepatoblastoma. Transplantation. 2002;73:90-92.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 45]  [Cited by in F6Publishing: 27]  [Article Influence: 2.4]  [Reference Citation Analysis (0)]
131.  Reyes JD, Carr B, Dvorchik I, Kocoshis S, Jaffe R, Gerber D, Mazariegos GV, Bueno J, Selby R. Liver transplantation and chemotherapy for hepatoblastoma and hepatocellular cancer in childhood and adolescence. J Pediatr. 2000;136:795-804.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 112]  [Article Influence: 5.3]  [Reference Citation Analysis (0)]
132.  Tsoucalas G, Karamanou M, Androutsos G. The eminent German pathologist Siegfried Oberndorfer (1876-1944) and his landmark work on carcinoid tumors. Ann of Gastroenterol. 2011;24:98-100.  [PubMed]  [DOI]  [Cited in This Article: ]
133.  Toledo SP, Lourenço DM, Toledo RA. A differential diagnosis of inherited endocrine tumors and their tumor counterparts. Clinics (Sao Paulo). 2013;68:1039-1056.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 10]  [Cited by in F6Publishing: 3]  [Article Influence: 1.4]  [Reference Citation Analysis (0)]
134.  Oberg K, Castellano D. Current knowledge on diagnosis and staging of neuroendocrine tumors. Cancer Metastasis Rev. 2011;30 Suppl 1:3-7.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 123]  [Cited by in F6Publishing: 63]  [Article Influence: 12.3]  [Reference Citation Analysis (0)]
135.  Ramage JK, Davies AH, Ardill J, Bax N, Caplin M, Grossman A, Hawkins R, McNicol AM, Reed N, Sutton R. Guidelines for the management of gastroenteropancreatic neuroendocrine (including carcinoid) tumours. Gut. 2005;54 Suppl 4:iv1-i16.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 173]  [Cited by in F6Publishing: 152]  [Article Influence: 10.8]  [Reference Citation Analysis (0)]
136.  Banfield A, Green S, Ramage JK. Neuroendocrine tumour management: a team approach. Hosp Med. 2005;66:37-42.  [PubMed]  [DOI]  [Cited in This Article: ]
137.  O'Grady JG. Treatment options for other hepatic malignancies. Liver Transpl. 2000;6:S23-S29.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 38]  [Cited by in F6Publishing: 30]  [Article Influence: 1.8]  [Reference Citation Analysis (0)]
138.  Pavel M, Baudin E, Couvelard A, Krenning E, Öberg K, Steinmüller T, Anlauf M, Wiedenmann B, Salazar R. ENETS Consensus Guidelines for the management of patients with liver and other distant metastases from neuroendocrine neoplasms of foregut, midgut, hindgut, and unknown primary. Neuroendocrinology. 2012;95:157-176.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 525]  [Cited by in F6Publishing: 299]  [Article Influence: 58.3]  [Reference Citation Analysis (0)]
139.  Le Treut YP, Grégoire E, Klempnauer J, Belghiti J, Jouve E, Lerut J, Castaing D, Soubrane O, Boillot O, Mantion G. Liver transplantation for neuroendocrine tumors in Europe-results and trends in patient selection: a 213-case European liver transplant registry study. Ann Surg. 2013;257:807-815.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 127]  [Cited by in F6Publishing: 35]  [Article Influence: 15.9]  [Reference Citation Analysis (0)]
140.  Gedaly R, Daily MF, Davenport D, McHugh PP, Koch A, Angulo P, Hundley JC. Liver transplantation for the treatment of liver metastases from neuroendocrine tumors: an analysis of the UNOS database. Arch Surg. 2011;146:953-958.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 115]  [Cited by in F6Publishing: 70]  [Article Influence: 11.5]  [Reference Citation Analysis (0)]
141.  Nguyen NT, Harring TR, Goss JA, O’Mahony CA. Neuroendocrine Liver Metastases and Orthotopic Liver Transplantation: The US Experience. Int J Hepatol. 2011;2011:742890.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 37]  [Cited by in F6Publishing: 25]  [Article Influence: 3.7]  [Reference Citation Analysis (0)]
142.  Le Treut YP, Grégoire E, Belghiti J, Boillot O, Soubrane O, Mantion G, Cherqui D, Castaing D, Ruszniewski P, Wolf P. Predictors of long-term survival after liver transplantation for metastatic endocrine tumors: an 85-case French multicentric report. Am J Transplant. 2008;8:1205-1213.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 117]  [Cited by in F6Publishing: 72]  [Article Influence: 9.0]  [Reference Citation Analysis (0)]
143.  van Vilsteren FG, Baskin-Bey ES, Nagorney DM, Sanderson SO, Kremers WK, Rosen CB, Gores GJ, Hobday TJ. Liver transplantation for gastroenteropancreatic neuroendocrine cancers: Defining selection criteria to improve survival. Liver Transpl. 2006;12:448-456.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 98]  [Cited by in F6Publishing: 65]  [Article Influence: 6.5]  [Reference Citation Analysis (0)]
144.  Rosenau J, Bahr MJ, von Wasielewski R, Mengel M, Schmidt HH, Nashan B, Lang H, Klempnauer J, Manns MP, Boeker KH. Ki67, E-cadherin, and p53 as prognostic indicators of long-term outcome after liver transplantation for metastatic neuroendocrine tumors. Transplantation. 2002;73:386-394.  [PubMed]  [DOI]  [Cited in This Article: ]
145.  Olausson M, Friman S, Herlenius G, Cahlin C, Nilsson O, Jansson S, Wängberg B, Ahlman H. Orthotopic liver or multivisceral transplantation as treatment of metastatic neuroendocrine tumors. Liver Transpl. 2007;13:327-333.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 96]  [Cited by in F6Publishing: 68]  [Article Influence: 6.9]  [Reference Citation Analysis (0)]
146.  Mazzaferro V, Pulvirenti A, Coppa J. Neuroendocrine tumors metastatic to the liver: how to select patients for liver transplantation? J Hepatol. 2007;47:460-466.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 170]  [Cited by in F6Publishing: 105]  [Article Influence: 12.1]  [Reference Citation Analysis (0)]
147.  Hackl C, Gerken M, Loss M, Klinkhammer-Schalke M, Piso P, Schlitt HJ. A population-based analysis on the rate and surgical management of colorectal liver metastases in Southern Germany. Int J Colorectal Dis. 2011;26:1475-1481.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 27]  [Cited by in F6Publishing: 16]  [Article Influence: 2.7]  [Reference Citation Analysis (0)]
148.  Chapman WC. Liver transplantation for unresectable metastases to the liver: a new era in transplantation or a time for caution? Ann Surg. 2013;257:816-817.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 13]  [Cited by in F6Publishing: 5]  [Article Influence: 1.6]  [Reference Citation Analysis (0)]
149.  Foss A, Adam R, Dueland S. Liver transplantation for colorectal liver metastases: revisiting the concept. Transpl Int. 2010;23:679-685.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 51]  [Cited by in F6Publishing: 27]  [Article Influence: 4.6]  [Reference Citation Analysis (0)]
150.  Hagness M, Foss A, Line PD, Scholz T, Jørgensen PF, Fosby B, Boberg KM, Mathisen O, Gladhaug IP, Egge TS. Liver transplantation for nonresectable liver metastases from colorectal cancer. Ann Surg. 2013;257:800-806.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 148]  [Cited by in F6Publishing: 43]  [Article Influence: 18.5]  [Reference Citation Analysis (0)]
151.  Andersen MH, Dueland S, Hagness M, Vidnes T, Finstad ED, Wahl AK, Foss A. Quality of life following liver transplantation in patients with liver metastases from colorectal carcinoma. Scand J Caring Sci. 2012;26:713-719.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 9]  [Cited by in F6Publishing: 7]  [Article Influence: 1.0]  [Reference Citation Analysis (0)]
152.  Uskudar O, Raja K, Schiano TD, Fiel MI, del Rio Martin J, Chang C. Liver transplantation is possible in some patients with liver metastasis of colon cancer. Transplant Proc. 2011;43:2070-2074.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 10]  [Cited by in F6Publishing: 8]  [Article Influence: 1.0]  [Reference Citation Analysis (0)]
153.  Bachir NM, Larson AM. Adult liver transplantation in the United States. Am J Med Sci. 2012;343:462-469.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 23]  [Cited by in F6Publishing: 9]  [Article Influence: 2.6]  [Reference Citation Analysis (0)]