The long-term outcomes of patients with hepatocellular carcinoma after living donor liver transplantation: A comparison of right and left lobe grafts

Akinobu Taketomi, Ken Shirabe, Takeo Toshima, Kazutoyo Morita, Naotaka Hashimoto, Hiroto Kayashima, Toru Ikegami, Tomoharu Yoshizumi, Yuji Soejima, Yoshihiko Maehara

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Abstract

Purpose The feasibility of living donor liver transplantation (LDLT) using left lobe (LL) grafts has been demonstrated. However, the long-term outcome of the hepatocellular carcinoma (HCC) patients with LL grafts has not been elucidated. The aim of this study was to analyze the long-term outcomes after LDLT for HCC according to the graft type. Methods A retrospective analysis was performed evaluating the outcomes of LL graft recipients (n = 82) versus recipients of RL grafts (n = 46). The analysis endpoints were the overall and recurrence-free survival after LDLT. The demographics of both recipients and donors, and the tumor characteristics associated with the graft type were also analyzed. Results The graft volume (436 ± 74 g), as well as the graft volume-standard liver volume rate (38.3 ± 6.2%) of the LL graft group were significantly decreased as compared to those of the RL graft group (569 ± 82 g, 46.3 ± 6.7%; P>0.01). The 1-, 3-, 5- and 7-year overall survival rates of the LL graft group were 88.2, 80.2, 75.7 and 72.4%, respectively, which were not significantly different compared to those of the RL graft group (95.4, 87.3, 87.3 and 87.3%). The recurrence-free survival rates of the LL graft group (89.1% at 1 year, 78.8% at 3 years, 75.8% at 5 years and 70.3% at 7 years) were similar to those of the RL graft group (88.6, 88.6, 88.6 and 88.6%). The mean peak postoperative total bilirubin levels and duration of hospital stay after surgery for the LL grafting donors were significantly decreased as compared to those of the RL grafting donors (P>0.01). The rate of severe complications (over Clavien's IIIa) associated with LL graft procurement was 6.2%, which was lower than that in the RL graft group (15.6%). Conclusions The long-term outcomes in the HCC patients with LL grafts were similar to those of patients receiving RL grafts, and the outcomes of the donors of LL grafts were more favorable. Therefore, LL grafts should be considered when selecting LDLT for HCC to ensure donor safety.

Original languageEnglish
Pages (from-to)559-564
Number of pages6
JournalSurgery today
Volume42
Issue number6
DOIs
Publication statusPublished - Jun 1 2012

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Living Donors
Liver Transplantation
Hepatocellular Carcinoma
Transplants
Tissue Donors
Survival Rate
Recurrence

All Science Journal Classification (ASJC) codes

  • Surgery

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The long-term outcomes of patients with hepatocellular carcinoma after living donor liver transplantation : A comparison of right and left lobe grafts. / Taketomi, Akinobu; Shirabe, Ken; Toshima, Takeo; Morita, Kazutoyo; Hashimoto, Naotaka; Kayashima, Hiroto; Ikegami, Toru; Yoshizumi, Tomoharu; Soejima, Yuji; Maehara, Yoshihiko.

In: Surgery today, Vol. 42, No. 6, 01.06.2012, p. 559-564.

Research output: Contribution to journalArticle

Taketomi, Akinobu ; Shirabe, Ken ; Toshima, Takeo ; Morita, Kazutoyo ; Hashimoto, Naotaka ; Kayashima, Hiroto ; Ikegami, Toru ; Yoshizumi, Tomoharu ; Soejima, Yuji ; Maehara, Yoshihiko. / The long-term outcomes of patients with hepatocellular carcinoma after living donor liver transplantation : A comparison of right and left lobe grafts. In: Surgery today. 2012 ; Vol. 42, No. 6. pp. 559-564.
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abstract = "Purpose The feasibility of living donor liver transplantation (LDLT) using left lobe (LL) grafts has been demonstrated. However, the long-term outcome of the hepatocellular carcinoma (HCC) patients with LL grafts has not been elucidated. The aim of this study was to analyze the long-term outcomes after LDLT for HCC according to the graft type. Methods A retrospective analysis was performed evaluating the outcomes of LL graft recipients (n = 82) versus recipients of RL grafts (n = 46). The analysis endpoints were the overall and recurrence-free survival after LDLT. The demographics of both recipients and donors, and the tumor characteristics associated with the graft type were also analyzed. Results The graft volume (436 ± 74 g), as well as the graft volume-standard liver volume rate (38.3 ± 6.2{\%}) of the LL graft group were significantly decreased as compared to those of the RL graft group (569 ± 82 g, 46.3 ± 6.7{\%}; P>0.01). The 1-, 3-, 5- and 7-year overall survival rates of the LL graft group were 88.2, 80.2, 75.7 and 72.4{\%}, respectively, which were not significantly different compared to those of the RL graft group (95.4, 87.3, 87.3 and 87.3{\%}). The recurrence-free survival rates of the LL graft group (89.1{\%} at 1 year, 78.8{\%} at 3 years, 75.8{\%} at 5 years and 70.3{\%} at 7 years) were similar to those of the RL graft group (88.6, 88.6, 88.6 and 88.6{\%}). The mean peak postoperative total bilirubin levels and duration of hospital stay after surgery for the LL grafting donors were significantly decreased as compared to those of the RL grafting donors (P>0.01). The rate of severe complications (over Clavien's IIIa) associated with LL graft procurement was 6.2{\%}, which was lower than that in the RL graft group (15.6{\%}). Conclusions The long-term outcomes in the HCC patients with LL grafts were similar to those of patients receiving RL grafts, and the outcomes of the donors of LL grafts were more favorable. Therefore, LL grafts should be considered when selecting LDLT for HCC to ensure donor safety.",
author = "Akinobu Taketomi and Ken Shirabe and Takeo Toshima and Kazutoyo Morita and Naotaka Hashimoto and Hiroto Kayashima and Toru Ikegami and Tomoharu Yoshizumi and Yuji Soejima and Yoshihiko Maehara",
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T1 - The long-term outcomes of patients with hepatocellular carcinoma after living donor liver transplantation

T2 - A comparison of right and left lobe grafts

AU - Taketomi, Akinobu

AU - Shirabe, Ken

AU - Toshima, Takeo

AU - Morita, Kazutoyo

AU - Hashimoto, Naotaka

AU - Kayashima, Hiroto

AU - Ikegami, Toru

AU - Yoshizumi, Tomoharu

AU - Soejima, Yuji

AU - Maehara, Yoshihiko

PY - 2012/6/1

Y1 - 2012/6/1

N2 - Purpose The feasibility of living donor liver transplantation (LDLT) using left lobe (LL) grafts has been demonstrated. However, the long-term outcome of the hepatocellular carcinoma (HCC) patients with LL grafts has not been elucidated. The aim of this study was to analyze the long-term outcomes after LDLT for HCC according to the graft type. Methods A retrospective analysis was performed evaluating the outcomes of LL graft recipients (n = 82) versus recipients of RL grafts (n = 46). The analysis endpoints were the overall and recurrence-free survival after LDLT. The demographics of both recipients and donors, and the tumor characteristics associated with the graft type were also analyzed. Results The graft volume (436 ± 74 g), as well as the graft volume-standard liver volume rate (38.3 ± 6.2%) of the LL graft group were significantly decreased as compared to those of the RL graft group (569 ± 82 g, 46.3 ± 6.7%; P>0.01). The 1-, 3-, 5- and 7-year overall survival rates of the LL graft group were 88.2, 80.2, 75.7 and 72.4%, respectively, which were not significantly different compared to those of the RL graft group (95.4, 87.3, 87.3 and 87.3%). The recurrence-free survival rates of the LL graft group (89.1% at 1 year, 78.8% at 3 years, 75.8% at 5 years and 70.3% at 7 years) were similar to those of the RL graft group (88.6, 88.6, 88.6 and 88.6%). The mean peak postoperative total bilirubin levels and duration of hospital stay after surgery for the LL grafting donors were significantly decreased as compared to those of the RL grafting donors (P>0.01). The rate of severe complications (over Clavien's IIIa) associated with LL graft procurement was 6.2%, which was lower than that in the RL graft group (15.6%). Conclusions The long-term outcomes in the HCC patients with LL grafts were similar to those of patients receiving RL grafts, and the outcomes of the donors of LL grafts were more favorable. Therefore, LL grafts should be considered when selecting LDLT for HCC to ensure donor safety.

AB - Purpose The feasibility of living donor liver transplantation (LDLT) using left lobe (LL) grafts has been demonstrated. However, the long-term outcome of the hepatocellular carcinoma (HCC) patients with LL grafts has not been elucidated. The aim of this study was to analyze the long-term outcomes after LDLT for HCC according to the graft type. Methods A retrospective analysis was performed evaluating the outcomes of LL graft recipients (n = 82) versus recipients of RL grafts (n = 46). The analysis endpoints were the overall and recurrence-free survival after LDLT. The demographics of both recipients and donors, and the tumor characteristics associated with the graft type were also analyzed. Results The graft volume (436 ± 74 g), as well as the graft volume-standard liver volume rate (38.3 ± 6.2%) of the LL graft group were significantly decreased as compared to those of the RL graft group (569 ± 82 g, 46.3 ± 6.7%; P>0.01). The 1-, 3-, 5- and 7-year overall survival rates of the LL graft group were 88.2, 80.2, 75.7 and 72.4%, respectively, which were not significantly different compared to those of the RL graft group (95.4, 87.3, 87.3 and 87.3%). The recurrence-free survival rates of the LL graft group (89.1% at 1 year, 78.8% at 3 years, 75.8% at 5 years and 70.3% at 7 years) were similar to those of the RL graft group (88.6, 88.6, 88.6 and 88.6%). The mean peak postoperative total bilirubin levels and duration of hospital stay after surgery for the LL grafting donors were significantly decreased as compared to those of the RL grafting donors (P>0.01). The rate of severe complications (over Clavien's IIIa) associated with LL graft procurement was 6.2%, which was lower than that in the RL graft group (15.6%). Conclusions The long-term outcomes in the HCC patients with LL grafts were similar to those of patients receiving RL grafts, and the outcomes of the donors of LL grafts were more favorable. Therefore, LL grafts should be considered when selecting LDLT for HCC to ensure donor safety.

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