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Hepatocellular carcinoma recurrence in living and deceased donor liver transplantation: a systematic review and meta-analysis

BACKGROUND: Although a number of technical problems and donor safety issues associated with living donor liver transplantation (LDLT) have been resolved, some initial clinical studies showed an increased risk of hepatocellular carcinoma (HCC) recurrence in LDLT. This meta-analysis was conducted to a...

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Autores principales: Zhang, Hai-Ming, Shi, Yue-Xian, Sun, Li-Ying, Zhu, Zhi-Jun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6616234/
https://www.ncbi.nlm.nih.gov/pubmed/31058674
http://dx.doi.org/10.1097/CM9.0000000000000287
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author Zhang, Hai-Ming
Shi, Yue-Xian
Sun, Li-Ying
Zhu, Zhi-Jun
author_facet Zhang, Hai-Ming
Shi, Yue-Xian
Sun, Li-Ying
Zhu, Zhi-Jun
author_sort Zhang, Hai-Ming
collection PubMed
description BACKGROUND: Although a number of technical problems and donor safety issues associated with living donor liver transplantation (LDLT) have been resolved, some initial clinical studies showed an increased risk of hepatocellular carcinoma (HCC) recurrence in LDLT. This meta-analysis was conducted to assess differences in tumor recurrence between LDLT and deceased donor liver transplantation (DDLT). METHODS: After systematic retrievals of studies about LDLT and DDLT for HCC, articles were selected with a rationale of emphasizing inter-group comparability. Results from multivariate analyses were combined and discussed together with univariate analyses. In subgroup analysis, the impact of organ allocation policy was taken into consideration. RESULTS: Seven articles were included in the meta-analysis. Overall, a salient result that emerged from the seven studies was a significant increased risk of HCC recurrence in the LDLT group than in the DDLT group (P = 0.01). The most significant increase in hazard ratio was found in studies where organs tended to be allocated to non-tumor patients. CONCLUSIONS: An increased risk for HCC recurrence in LDLT as compared with DDLT patients was found. The relatively shorter preoperative observation windows in LDLT may lead to fewer cases of HCC with invasive features being screened out, which may provide a possible explanation for the high rates of HCC recurrence.
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spelling pubmed-66162342019-07-22 Hepatocellular carcinoma recurrence in living and deceased donor liver transplantation: a systematic review and meta-analysis Zhang, Hai-Ming Shi, Yue-Xian Sun, Li-Ying Zhu, Zhi-Jun Chin Med J (Engl) Meta Analysis BACKGROUND: Although a number of technical problems and donor safety issues associated with living donor liver transplantation (LDLT) have been resolved, some initial clinical studies showed an increased risk of hepatocellular carcinoma (HCC) recurrence in LDLT. This meta-analysis was conducted to assess differences in tumor recurrence between LDLT and deceased donor liver transplantation (DDLT). METHODS: After systematic retrievals of studies about LDLT and DDLT for HCC, articles were selected with a rationale of emphasizing inter-group comparability. Results from multivariate analyses were combined and discussed together with univariate analyses. In subgroup analysis, the impact of organ allocation policy was taken into consideration. RESULTS: Seven articles were included in the meta-analysis. Overall, a salient result that emerged from the seven studies was a significant increased risk of HCC recurrence in the LDLT group than in the DDLT group (P = 0.01). The most significant increase in hazard ratio was found in studies where organs tended to be allocated to non-tumor patients. CONCLUSIONS: An increased risk for HCC recurrence in LDLT as compared with DDLT patients was found. The relatively shorter preoperative observation windows in LDLT may lead to fewer cases of HCC with invasive features being screened out, which may provide a possible explanation for the high rates of HCC recurrence. Wolters Kluwer Health 2019-07-05 2019-07-05 /pmc/articles/PMC6616234/ /pubmed/31058674 http://dx.doi.org/10.1097/CM9.0000000000000287 Text en Copyright © 2019 The Chinese Medical Association, produced by Wolters Kluwer, Inc. under the CC-BY-NC-ND license. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0
spellingShingle Meta Analysis
Zhang, Hai-Ming
Shi, Yue-Xian
Sun, Li-Ying
Zhu, Zhi-Jun
Hepatocellular carcinoma recurrence in living and deceased donor liver transplantation: a systematic review and meta-analysis
title Hepatocellular carcinoma recurrence in living and deceased donor liver transplantation: a systematic review and meta-analysis
title_full Hepatocellular carcinoma recurrence in living and deceased donor liver transplantation: a systematic review and meta-analysis
title_fullStr Hepatocellular carcinoma recurrence in living and deceased donor liver transplantation: a systematic review and meta-analysis
title_full_unstemmed Hepatocellular carcinoma recurrence in living and deceased donor liver transplantation: a systematic review and meta-analysis
title_short Hepatocellular carcinoma recurrence in living and deceased donor liver transplantation: a systematic review and meta-analysis
title_sort hepatocellular carcinoma recurrence in living and deceased donor liver transplantation: a systematic review and meta-analysis
topic Meta Analysis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6616234/
https://www.ncbi.nlm.nih.gov/pubmed/31058674
http://dx.doi.org/10.1097/CM9.0000000000000287
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