Living Donor Versus Deceased Donor Liver Transplantation for HCC
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REVIEW ARTICLE
Living Donor Versus Deceased Donor Liver Transplantation for HCC Sait Murat Doğan 1
&
Koray Kutlutürk 1
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Introduction Liver transplantation is the definitive treatment modality of the patients having an end-stage liver disease with hepatocellular carcinoma. Discussion The number of living donor liver transplantations has been increased because of the deceased donor organ shortage, especially in Asian countries. Conclusion Reports of different clinics about the postoperative course and tumor recurrence rates comparing living donor versus deceased donor liver transplantations, besides patient selection criteria, are reviewed along with our clinic’s experiences. Keywords Hepatocellular carcinoma . Living donor liver transplantation . Deceased donor liver transplantation
Abbreviations HCC Hepatocellular carcinoma LDLT Living donor liver transplantation DDLT Deceased donor liver transplantation
Introduction Being the most common cancer of the liver and one of the important reasons of cancer related death; hepatocellular carcinoma (HCC) is one of the major health problems in the world [1]. Milan criteria was publicated in 1996, and thereafter, deceased donor liver transplantation (DDLT) has become an effective treatment option for patients with cirrhosis and HCC [2]. As an alternative treatment for end-stage liver disease, living donor liver transplantation (LDLT) has been developed in Asian countries where the deceased donor is rare. Also, LDLT has become a definitive treatment option for cirrhotic patients with HCC as well [3]. The University of California San Francisco criteria (UCSF) [4], Barcelona Clinic Liver Cancer extended criteria (BCLC) * Sait Murat Doğan [email protected] 1
Department of Surgery and Liver Transplantation Institute, İnönü University Faculty of Medicine, Elazığ yolu 10.km, 44280 Malatya, Turkey
[5], up-to-seven criteria [6], Extended Toronto criteria (ETC) [7], Hangzhou criteria (HC) [8], and along with our group at Malatya İnönü University criteria [9] and different extended criteria have tried to been defined to overcome limitations of Milan criteria. With the increased number of LDLT cases for cirrhotic patients with HCC, a debate has begun comparing the impact of LDLT, mainly on the tumor recurrence, with DDLT [10, 11]. The aim of this review was to compare LDLT and DDLT in the perspective of the today’s opinions and reports of different clinics regarding especially the outcome differences and the tumor recurrence in the follow-up of the patients who had liver transplantation for cirrhosis with HCC.
Discussion Graft type is not the only difference between LDLT and DDLT. There are many differences related to waiting time, quality of the graft, and cold ischemic time. Shortened waiting period for transplantation in LDLT in contrast to DDLT is believed to prevent tumor growth during the waiting period. This can be a significant benefit in patients with HCC, since tumor growth worsens p
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