alexa Priority of candidates with hepatocellular carcinoma awaiting liver transplantation can be reduced after successful bridge therapy.
Clinical Research

Clinical Research

Journal of Clinical and Experimental Transplantation

Author(s): Cucchetti A, Cescon M, Bigonzi E, Piscaglia F, Golfieri R,

Abstract Share this page

Abstract The allocation rules for patients with hepatocellular carcinoma (HCC) who are awaiting liver transplantation (LT) are a difficult issue and are continually evolving. To reduce tumor progression or down-stage advanced disease, most transplant centers have adopted the practice of treating HCC candidates with resection or locoregional therapies. This study was designed to assess the effectiveness of bridge therapy in preventing removal from the waiting list for death/sickness severity or tumor progression beyond the Milan criteria and in determining posttransplant outcomes. The removal rates for 315 adult patients with HCC who were listed for LT were analyzed and were correlated to responses to bridge therapy with a competing risk analysis. The 3-, 6-, and 12-month dropout rates were 3.5\%, 6.5\%, and 19.9\%, respectively, and they were significantly affected by the Model for End-Stage Liver Disease score (P = 0.032), the tumor stage at diagnosis (P = 0.041), and the response to bridge therapy (P < 0.001). The stratification of candidates by the tumor stage and the response to bridge therapy showed that patients with T2 tumors who achieved only a partial response or no response to bridge therapy had the highest dropout rates, and they were followed by patients with successfully down-staged T3-T4a tumors (P = 0.037). Patients with T2 tumors who had a complete response and patients with T1 tumors had similar dropout rates (P = 0.964). The response to bridge therapy significantly affected both the recurrence rate of 176 transplant patients (P = 0.017) and the overall intention-to-treat survival rate (P = 0.001). In conclusion, the response to therapy is a potentially effective tool for prioritizing HCC patients for LT as well as select cases with different risks of tumor recurrence after transplantation. Copyright © 2011 American Association for the Study of Liver Diseases. This article was published in Liver Transpl and referenced in Journal of Clinical and Experimental Transplantation

Relevant Expert PPTs

Relevant Speaker PPTs

Recommended Conferences

  • 2nd International Conference on Plastic and Aesthetic Surgery & Medicine
    July 27-28, 2017 Vancouver,Canada

  • 2nd International Conference on Anesthesia and Analgesia
    September 07-08, 2017 London, U.K
  • 21st International Conference on Clinical & Experimental Cardiology
    October 16-18, 2017 Chicago, USA

  • 10th World Congress on Stem Cell and Biobanking
    October 23-24, 2017 Osaka, Japan
  • 9th World Congress on Immunity, Inflammation and Immunotherapies
    November 02-03, 2017 Atlanta, Georgia, USA
  • 10th International Conference on Clinical & Experimental Ophthalmology
    November 21- 23, 2016 Dubai, UAE

Relevant Topics

Peer Reviewed Journals
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version