Review
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World J Hepatol. Sep 27, 2014; 6(9): 626-631
Published online Sep 27, 2014. doi: 10.4254/wjh.v6.i9.626
Living-donor vs deceased-donor liver transplantation for patients with hepatocellular carcinoma
Nobuhisa Akamatsu, Yasuhiko Sugawara, Norihiro Kokudo
Nobuhisa Akamatsu, Yasuhiko Sugawara, Norihiro Kokudo, Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Tokyo 113-8655, Japan
Author contributions: All authors contributed equally to this work.
Correspondence to: Yasuhiko Sugawara, MD, Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. yasusuga-tky@umin.ac.jp
Telephone: +81-3-38155411 Fax: +81-3-56843989
Received: April 24, 2014
Revised: July 29, 2014
Accepted: August 27, 2014
Published online: September 27, 2014
Abstract

With the increasing prevalence of living-donor liver transplantation (LDLT) for patients with hepatocellular carcinoma (HCC), some authors have reported a potential increase in the HCC recurrence rates among LDLT recipients compared to deceased-donor liver transplantation (DDLT) recipients. The aim of this review is to encompass current opinions and clinical reports regarding differences in the outcome, especially the recurrence of HCC, between LDLT and DDLT. While some studies report impaired recurrence - free survival and increased recurrence rates among LDLT recipients, others, including large database studies, report comparable recurrence - free survival and recurrence rates between LDLT and DDLT. Studies supporting the increased recurrence in LDLT have linked graft regeneration to tumor progression, but we found no association between graft regeneration/initial graft volume and tumor recurrence among our 125 consecutive LDLTs for HCC cases. In the absence of a prospective study regarding the use of LDLT vs DDLT for HCC patients, there is no evidence to support the higher HCC recurrence after LDLT than DDLT, and LDLT remains a reasonable treatment option for HCC patients with cirrhosis.

Keywords: Deceased donor liver transplantation, Hepatocellular carcinoma, Living donors, Living-donor liver transplantation, Recurrence

Core tip: The current opinions and clinical reports regarding differences in the recurrence of hepatocellular carcinoma (HCC) between living donor liver transplantation (LDLT) and deceased donor liver transplantation (DDLT) were reviewed. In the absence of a prospective study regarding the use of LDLT vs DDLT for HCC patients, only with some retrospective studies with conflicting results, there is no evidence to support the higher HCC recurrence after LDLT than DDLT, and LDLT remains a reasonable treatment option for HCC patients with cirrhosis.