Post-Transplant Outcomes in Patients with Previously Treated Extrahepatic Malignancies Undergoing Living Donor Liver Transplantation.

Abstract

BACKGROUND Post-transplant outcomes were analyzed in adult patients with primary extrahepatic malignancies (EHM) who underwent living donor liver transplantation (LDLT). Few studies to date have analyzed post-transplant outcomes in adult patients with primary extrahepatic malignancies (EHM) who underwent LDLT. MATERIAL AND METHODS The study cohort included 109 patients who were treated for EHM more than 6 months before LDLT between January 2000 and December 2022. The clinicopathological characteristics of EHMs and outcomes of LDLT, including EHM recurrence and patient survival, were analyzed. RESULTS The most common primary EHM was stomach cancer (27.5%), followed by thyroid (11.0%), breast (11.0%), colorectal (10.1%), and kidney (10.1%) cancer. The mean and median intervals between final EHM treatment and LT were 84.9±78.0 months and 27 months (range: 6-336 months), respectively. During mean follow-up period of 84.9±78.0 months, 15 patients died. The 1-, 5-, 10-, and 20-year patient survival rates were 96.3%, 88.5%, 85.0%, and 70.8%, respectively. Five patients (4.6%) experienced post-transplant EHM recurrence, with 4 dying due to sepsis during EHM treatment (n=2), progression of EHM recurrence (n=1), and pneumonia (n=1). The mean and median intervals between LT and recurrence of pretransplant EHM were 71.6±82.8 months and 25 months (range: 19-213 months), respectively. The cumulative 1-, 5-, 10-, and 20-year EHM recurrence rates were 0%, 3.1%, 4.6%, and 18.3%, respectively. CONCLUSIONS Patients with previously treated EHMs may be considered for LDLT following careful multidisciplinary evaluation and implementation of individualized post-transplant surveillance strategies.