Liver transplantation for malignancy: Current treatment strategies and future perspectives

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]

HCC: Hepatocellular carcinoma; FLC: Fibrolamellar carcinoma; CCA: Cholangiocellular adenocarcinoma.

Table 2 Liver transplantation for hepatic epithelioid hemangioendothelioma

Database	Author	Year	Year of LT	n	Age of patients	Female	Mean fullow-up	Overall survival in %			DFS in %			LDLT	Extrahep.	Recurrence
								1 yr	3 yr	5 yr	1 yr	3 yr	5 yr
Mayo	Grotz	2010	1984-2007	11	21-79 yr (mean 46.7 yr)	77%	42 mo	91	73	73	64	46	46	NR	18%	NR
UNOS	Rodriguez	2008	1987-2005	110	0-70 yr (median 36 yr)	68%	24 mo	80	68	64	NR	NR	NR	n.t.	NR	NR
Canada	Nudo	2008	1991-2005	11	18-52 yr (mean 38.7 yr)	77%	81 mo	82	82	calc 82	80	69	69	0%	36%	45%
Europe	Lerut	2007	1989-2004	59	4-65 yr (median 41 yr)	57%	79 mo	93	NR	83	90	NR	82	5%	17%	24%
Review	Mehrabi	2006	1984-2006	128	mean 41.7 yr	58%	NR	96	77	54	NR	NR	NR	2%	NR	NR
Pittsburgh	Madariaga	1995	1976-1993	17	28-58	53%	56 mo	100	86	67	88	68	59	NR	NR	NR
Review	Yokoyama	1990	1980-1988	8	NR	NR	25 mo	88	73	48	NR	NR	NR	NR	NR	50%
Pittsburgh	Marino	1988	1963-1987	10	24-52.5 yr (median 29.5 yr)	60%	NR	NR	NR	calc 76	NR	NR	NR	NR	50%	30%

LT: Liver transplantation; NR: Not reported; DFS: Disease-free survival; LDLT: Living-donor liver transplantation; UNOS: United Network for Organ Sharing.

Table 3 Liver transplantation for hepatoblastoma

Database	Author	Year	Year of LT	n	Age of patients at LT	% female	Median FU	Overall survival in %			LDLT
								1 yr	3 yr	5 yr
SIOPEL-3HR	Zsiros	2010	1998-2004	31	< 16 yr (median 21 mo)	NR	54 mo	NR	75%	NR	NR
Chicago/Toronto	Browne	2008	1990-2004	14	18 mo-13 yr (mean 57 mo)	36	46 mo	71% @ 46 mo			NR
London	Faraj	2008	1993-2007	25	0.5-10 yr (median 2.5 yr)	32	6.8 yr	91		78	28%
Stanford	Beaunoyer	2007	1988-2006	15	0.3-9.7 yr (mean 2.6 yr)	47	3.3 ± 3.5 yr	87	87	87	0
Spain	Avila	2006		11	6 mo-14 yr			91	91	82	25%
UNOS review	Austin	2006	1987-2004	135	2.9 ± 2.5 yr	38		79		69
Texas	Mejia	2005	1995-2003	10	mean 5.8 yr	50	Mean 10.8 yr	70% @ last FU (mean 10.8 yr)			20%
Kyoto	Kasahara	2005	1990-2004	14	NR	NR	NR	78.6	NR	65.5	100%
SIOPEL-1	Otte	2004	1990-1994	12	1.25-11.6 yr (median 3.8 yr)	42	117 mo	NR	NR	75	NR
Dallas	Molmenti	2002	1984-2000	9	6 mo-16 yr (mean 6.4 yr)	44	NR	NR	67%	NR	0%
France	Chardot	2002	1998-1999	4	10-60 mo (mean 17 mo)	NR	NR	75% at last FU (13-24 mo)			100%
Birmingham	Pimpalwar	2002	1991-2000	12	0.15-8.78 yr at diag. (median 1.32 yr)	NR	NR	NR	93%	83%	0
Pittsburgh	Reyes	2000	1989-1998	12	NR	NR	NR	92	92	83	0

LT: Liver transplantation; FU: Follow-up; LDLT: Living-donor liver transplantation; NR: Not reported; UNOS: United Network for Organ Sharing.

Table 4 Liver transplantation for hepatic metastases of neuroendocrine tumors: reports with > 100 patients

Database	Author	Year	Year of LT	n	Age of patients	Female	Follow-up	Overall survival in %			DFS in %			LDLT	Recurrence
								1 yr	3 yr	5 yr	1 yr	3 yr	5 yr
Europe	LeTreut	2013	1982-2009	213	Mean 46 yr	46%	Mean 56 ± 49 mo	81	65	52	65	40	30	6%	53%
UNOS	Gedaly	2011	1988-2008	150	Mean 45 yr	44%	Mean 36.8 mo	81	65	49	NR	NR	32	7%	NR
UNOS	N'Guyen	2011	1988-2011	194	Mean 45 yr	46%	NR	80	61	49	NR	NR	NR	NR	NR
UNOS	N‘Guyen	2011	2002-2011	110	Mean 45 yr	46%	NR	85	65	58	NR	NR	NR	NR	NR
France	LeTreut	2008	1989-2005	85	Mean 46 yr	46%	Mean 46 ± 47 mo	72	59	47	56	37	20	2%	NR
Review	Lehnert	1998	1981-1997	103	Median 48 yr	50%		Calculated 60		Calculated 47			Calculated 24	NR	40%

LT: Liver transplantation; DFS: Disease-free survival; LDLT: Living-donor liver transplantation; NR: Not reported; UNOS: United Network for Organ Sharing.