Key points are not available for this paper at this time.
Background: Challenging clinical circumstances and high demand for liver transplantation have led to a refinement in the recipient selection criteria.This study aims to investigate the hypothesis that surgical outcomes in living donor liver transplantation (LDLT) for hepatocellular carcinoma (HCC) have improved over time with the shift from morphological to biological criteria.Methods: A retrospective analysis was conducted on 942 adult HCC patients underwent LDLT at Seoul National University Hospital between 2000 and 2022.Study populations were divided into Group A (2000.01.01-2011.06.30, n=314) and Group B (2011.07.01-2022.06.30, n=628).Baseline characteristics, perioperative factors, and survival outcomes were compared.Results: Group B demonstrated higher recurrence-free survival (RFS) compared to Group A (p=0.03).Additionally, Group B exhibited superior overall survival rates at the 1-, 3-, and 5-year intervals (95.9%, 87.9%, 84.6%, p<0.01).Moreover, Group B had a significantly lower recurrence rate (p=0.02) and mortality rate (p<0.01).The median time to recurrence was 9.1 months (interquartile range IQR 3.9-21.8)for Group A and 11.4 months (IQR 6.6-18.5)for Group B (p=0.92).Furthermore, Group A's median tumor-bearing survival was 12.3 months (IQR 5.2-26.1),which was significantly shorter than Group B's 20.0 months (IQR 5.4-25.7)(p<0.01). Conclusion:The use of biological tumor markers in patient selection criteria has significantly improved the effectiveness of HCC treatment in LDLT and should be encouraged for pervasive use.
Gongor et al. (Thu,) studied this question.