Hepatocellular carcinoma recurrence in living and deceased donor liver transplantation: a systematic review and meta-analysis
10.1097/CM9.0000000000000287
- Author:
Hai-Ming ZHANG
1
;
Yue-Xian SHI
2
;
Li-Ying SUN
1
;
Zhi-Jun ZHU
1
Author Information
1. Liver Transplantation Center, National Clinical Research Center for Digestive Diseases and Beijing Key Laboratory of Tolerance Induction and Organ Protection in Transplantation, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
2. Peking University School of Nursing, Beijing 100191, China
- Publication Type:Journal Article
- Keywords:
Living donor liver transplantation;
Deceased donor liver transplantation;
Hepatocellular carcinoma;
Meta-analysis
- From:
Chinese Medical Journal
2019;132(13):1599-1609
- CountryChina
- Language:English
-
Abstract:
Background:Although a number of technical problems and donor safety issues associated with living donor liver transplantation (LDLT) have been resolved, some initial clinical studies showed an increased risk of hepatocellular carcinoma (HCC) recurrence in LDLT. This meta-analysis was conducted to assess differences in tumor recurrence between LDLT and deceased donor liver transplantation (DDLT).
Methods:After systematic retrievals of studies about LDLT and DDLT for HCC, articles were selected with a rationale of emphasizing inter-group comparability. Results from multivariate analyses were combined and discussed together with univariate analyses. In subgroup analysis, the impact of organ allocation policy was taken into consideration.
Results:Seven articles were included in the meta-analysis. Overall, a salient result that emerged from the seven studies was a significant increased risk of HCC recurrence in the LDLT group than in the DDLT group (P = 0.01). The most significant increase in hazard ratio was found in studies where organs tended to be allocated to non-tumor patients.
Conclusions:An increased risk for HCC recurrence in LDLT as compared with DDLT patients was found. The relatively shorter preoperative observation windows in LDLT may lead to fewer cases of HCC with invasive features being screened out, which may provide a possible explanation for the high rates of HCC recurrence.
