Liver transplantation for intrahepatic cholangiocarcinoma: who, when and how.

IF 1.8 4区医学 Q3 TRANSPLANTATION

Current Opinion in Organ Transplantation Pub Date : 2024-04-01 Epub Date: 2024-01-23 DOI:10.1097/MOT.0000000000001136

Pablo Achurra, Eduardo Fernandes, Grainne O'Kane, Robert Grant, Mark Cattral, Gonzalo Sapisochin

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引用次数: 0

Abstract

Purpose of review: Using transplant oncology principles, selected patients with intrahepatic cholangiocarcinoma (iCCA) may achieve long-term survival after liver transplantation. Strategies for identifying and managing these patients are discussed in this review.

Recent findings: Unlike initial reports, several modern series have reported positive outcomes after liver transplantation for iCCA. The main challenges are in identifying the appropriate candidates and graft scarcity. Tumor burden and response to neoadjuvant therapies have been successfully used to identify favorable biology in unresectable cases. New molecular biomarkers will probably predict this response in the future. Also, new technologies and better strategies have been used to increase graft availability for these patients without affecting the liver waitlist.

Summary: Liver transplantation for the management of patients with unresectable iCCA is currently a reality under strict research protocols. Who is a candidate for transplantation, when to use neoadjuvant and locoregional therapies, and how to increase graft availability are the main topics of this review.

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肝内胆管癌肝移植：何人、何时、如何进行。

综述目的：利用移植肿瘤学原理，经过选择的肝内胆管癌（iCCA）患者可在肝移植后获得长期生存。本综述讨论了识别和管理这些患者的策略：与最初的报告不同，一些现代系列报告显示，iCCA 患者接受肝移植后取得了积极的疗效。主要的挑战在于确定合适的候选者和移植物的稀缺性。在无法切除的病例中，肿瘤负荷和对新辅助疗法的反应已被成功用于确定有利的生物学特性。未来，新的分子生物标记物可能会预测这种反应。此外，新技术和更好的策略已被用于在不影响肝脏等待名单的情况下增加这些患者的移植机会。摘要：目前，在严格的研究方案下，肝移植治疗不可切除的iCCA患者已成为现实。本综述的主要内容包括：哪些患者适合移植、何时使用新辅助治疗和局部治疗以及如何提高移植的可用性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Opinion in Organ Transplantation 医学-移植

CiteScore

4.10

自引率

4.50%

发文量

124

审稿时长

6-12 weeks

期刊介绍： Current Opinion in Organ Transplantation is an indispensable resource featuring key, up-to-date and important advances in the field from around the world. Led by renowned guest editors for each section, every bimonthly issue of Current Opinion in Organ Transplantation delivers a fresh insight into topics such as stem cell transplantation, immunosuppression, tolerance induction and organ preservation and procurement. With 18 sections in total, the journal provides a convenient and thorough review of the field and will be of interest to researchers, surgeons and other healthcare professionals alike.