Liver transplant assessment for hepatocellular carcinoma: a single-centre experience.

IF 3.1 Q3 GASTROENTEROLOGY & HEPATOLOGY
Frontline Gastroenterology Pub Date : 2025-02-10 eCollection Date: 2025-01-01 DOI:10.1136/flgastro-2024-102773
Rosemary Elizabeth Faulkes, Sean Morris, Oliwia Bolimowska, Zaira Rehman, Nadir Abbas, Bobby V M Dasari, Neil Rajoriya, Tahir Shah, Shishir Shetty
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引用次数: 0

Abstract

Objective: The incidence of hepatocellular carcinoma (HCC) continues to rise dramatically in the UK. Liver transplantation offers a potential cure and there is a large body of evidence demonstrating good outcomes. However, there is a paucity of data on the assessment, acceptance rates, and reasons for turning down liver transplantation in HCC.

Methods: We undertook an analysis of all patients with HCC referred for liver transplant assessment to a tertiary liver centre between January 2015 and January 2020. Patient and tumour demographics, assessment outcomes and overall survival were analysed. Multivariate analysis was performed on factors affecting listing decisions. To evaluate the impact of the COVID-19 pandemic, data collection was extended from March 2020 to March 2021.

Results: Of 263 patients with HCC who completed liver transplant assessment, 168 (64%) were accepted for listing. The most common factors associated with a decision not to list a patient were medical comorbidities (n=50, 56.2% of those not listed) and rapid tumour progression (n=25, 26.3%). Of patients who were listed, 145 (86.4%) received a liver transplant. Five year survival from the time of transplant assessment was 68% with transplant and 12% without.The pandemic resulted in more patients progressing out of criteria after listing. Prepandemic median dropout per annum was 2% (0%-9%), compared with 25% during the pandemic study period.

Conclusion: This study provides outcomes on patients with HCC referred for transplant assessment, identifying factors for non-listing and confirming the negative impact of decreased transplant activity during the pandemic on waiting list dropouts for HCC patients.

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肝细胞癌的肝移植评估:单中心经验。
目的:在英国,肝细胞癌(HCC)的发病率持续急剧上升。肝移植提供了一种潜在的治疗方法,并且有大量证据表明效果良好。然而,关于HCC的评估、接受率和拒绝肝移植的原因的数据缺乏。方法:我们对2015年1月至2020年1月期间转诊至三级肝脏中心进行肝移植评估的所有HCC患者进行了分析。分析患者和肿瘤人口统计学、评估结果和总生存期。对影响上市决策的因素进行多变量分析。为了评估COVID-19大流行的影响,数据收集从2020年3月延长至2021年3月。结果:在263例完成肝移植评估的HCC患者中,168例(64%)被接受列入名单。与决定不列出患者相关的最常见因素是医疗合并症(n=50,未列出患者的56.2%)和肿瘤快速进展(n=25, 26.3%)。在入选的患者中,145例(86.4%)接受了肝移植。移植评估后的5年生存率为68%,未移植为12%。大流行导致更多患者在上市后进展不符合标准。大流行前每年辍学率中位数为2%(0%-9%),而大流行研究期间为25%。结论:本研究提供了转介移植评估的HCC患者的结果,确定了未列入名单的因素,并确认了大流行期间移植活动减少对HCC患者等待名单退出的负面影响。
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来源期刊
Frontline Gastroenterology
Frontline Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
4.70
自引率
11.50%
发文量
93
期刊介绍: Frontline Gastroenterology publishes articles that accelerate adoption of innovative and best practice in the fields of gastroenterology and hepatology. Frontline Gastroenterology is especially interested in articles on multidisciplinary research and care, focusing on both retrospective assessments of novel models of care as well as putative future directions of best practice. Specifically Frontline Gastroenterology publishes articles in the domains of clinical quality, patient experience, service provision and medical education.
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