Japanese living donor liver transplantation criteria for hepatocellular carcinoma: nationwide cohort study-Reference-Cited by-同舟云学术

Japanese living donor liver transplantation criteria for hepatocellular carcinoma: nationwide cohort study

Published:2024-07-02 Issue:4 Volume:8 Page:
ISSN:2474-9842
Container-title:BJS Open
language:en
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Author:

Ohira Masahiro¹²,Aoki Gaku³,Orihashi Yasushi³,Yoshimura Kenichi²,Toshima Takeo⁴,Hatano Etsuro⁵,Eguchi Susumu⁶,Hibi Taizo⁷^ORCID,Hasegawa Kiyoshi⁸,Umeda Yuzo⁹,Hashimoto Takuya¹⁰,Hasegawa Yasushi¹¹^ORCID,Nobori Shuji¹²,Ogura Yasuhiro¹³,Nitta Hiroyuki¹⁴,Egawa Hiroto¹⁵,Eguchi Hidetoshi¹⁶^ORCID,Takada Yasutsugu¹⁷,Ueda Yoshihide¹⁸,Kasahara Mureo¹⁹,Kawachi Shigeyuki²⁰,Soejima Yuji²¹,Tokushige Katsutoshi²²,Nagano Hiroaki²³,Haga Hironori²⁴,Fukumoto Takumi²⁵,Mochida Satoshi²⁶,Umeshita Koji²⁷,Ohdan Hideki¹^ORCID, ,Mizuno Shugo,Kuboki Satoshi,Otsuka Masayuki,Kobayashi Takashi,Wakai Toshifumi,Ishigame Teruhide,Marubashi Shigeru,Watanabe Masaaki,Taketomi Akinobu,Nakamuma Shinichi,Yagi Shintaro,Wakiya Taichi,Ishido Keinosuke,Sawada Yu,Endo Itaru,Goto Yuichi,Hisaka Toru,Uryuhara Kenji,Sakuma Yasunari,Ichida Hirofumi,Saiura Akio,Haruki Koichiro,Ikegami Toru,Iso Yukihiro,Aoki Taku,Takahara Takeshi,Yokoo Hideki,Beck Yoshifumi,Miyagi Shigeto,Tokodai Kazuaki

Affiliation:

1. Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University , Hiroshima , Japan

2. Medical Centre for Translational and Clinical Research, Hiroshima University Hospital , Hiroshima , Japan

3. Department of Biostatistics, Clinical Research Centre in Hiroshima, Hiroshima University Hospital , Hiroshima , Japan

4. Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University , Fukuoka , Japan

5. Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, Kyoto University , Kyoto , Japan

6. Department of Surgery, Graduate School of Biomedical Sciences, Nagasaki University , Nagasaki , Japan

7. Department of Paediatric Surgery and Transplantation, Graduate School of Medical Sciences, Kumamoto University , Kumamoto , Japan

8. Division of Artificial Organ and Transplantation, Department of Surgery, Graduate School of Medicine, The University of Tokyo , Tokyo , Japan

9. Department of Gastroenterological Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University , Okayama , Japan

10. Division of Hepato-Biliary-Pancreatic and Transplantation Surgery, Japanese Red Cross Medical Centre , Tokyo , Japan

11. Department of Surgery, School of Medicine, Keio University , Tokyo , Japan

12. Department of Organ Transplantation and General Surgery, Kyoto Prefectural University of Medicine , Kyoto , Japan

13. Department of Transplantation Surgery, Nagoya University Hospital , Nagoya , Japan

14. Department of Surgery, School of Medicine, Iwate Medical University , Yahaba , Japan

15. Department of Hepato-Biliary-Pancreatic Surgery, Institute of Gastroenterology, Tokyo Women's Medical University , Tokyo , Japan

16. Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University , Osaka , Japan

17. Department of Hepato-Biliary-Pancreatic and Breast Surgery, Graduate School of Medicine, Ehime University , Toon , Japan

18. Division of Gastroenterology, Department of Internal Medicine, Graduate School of Medicine, Kobe University , Kobe , Japan

19. Organ Transplantation Centre, National Centre for Child Health and Development , Tokyo , Japan

20. Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Centre , Tokyo , Japan

21. Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation, and Paediatric Surgery, Department of Surgery, Shinshu University , Matsumoto , Japan

22. Department of Internal Medicine, Institute of Gastroenterology, Tokyo Women's Medical University , Tokyo , Japan

23. Department of Gastroenterological, Breast, and Endocrine Surgery, Graduate School of Medicine, Yamaguchi University , Ube , Japan

24. Department of Diagnostic Pathology, Kyoto University Hospital , Kyoto , Japan

25. Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Graduate School of Medicine, Kobe University , Kobe , Japan

26. Department of Gastroenterology and Hepatology, Faculty of Medicine, Saitama Medical University , Moroyama , Japan

27. Department of Surgery, Osaka International Cancer Institute , Osaka , Japan

Abstract

Abstract Background Validating the expanded criteria for living donor liver transplantation for hepatocellular carcinoma using national data is highly significant. The aim of this study was to evaluate the validity of the new Japanese criteria for living donor liver transplantation for hepatocellular carcinoma patients and identify factors associated with a poor prognosis using the Japanese national data set. Methods The study population comprised patients who underwent living donor liver transplantation for hepatocellular carcinoma at 37 centres in Japan between 2010 and 2018. In a nationwide survey, the overall survival and recurrence-free survival rates were evaluated based on the new Japanese criteria for applying the 5-5-500 rule when extending the indication beyond the Milan criteria. Prognostic factors within the Japanese criteria were determined using the Cox proportional hazards model. Results Patients within (485 patients) and beyond (31 patients) the Japanese criteria exhibited 5-year overall survival rates of 81% and 58% and 5-year recurrence-free survival rates of 77% and 48% respectively. Patients who met the Milan criteria, but not the 5-5-500 rule, had poorer outcomes. Multivariate analysis for 474 patients identified a neutrophil-to-lymphocyte ratio greater than or equal to 5 and a history of hepatectomy as independent risk factors. Conclusion This nationwide survey confirms the validity of the Japanese criteria. The poor prognostic factors within the Japanese criteria include a neutrophil-to-lymphocyte ratio greater than or equal to 5 and previous hepatectomy.

Funder

Japan Agency for Medical Research and Development

Publisher

Oxford University Press (OUP)

Link

https://academic.oup.com/bjsopen/article-pdf/8/4/zrae079/58904506/zrae079.pdf