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Outcomes After Liver Transplantation With Incidental Cholangiocarcinoma

Cholangiocarcinoma (CCA) is currently a contraindication to liver transplantation (LT) in the United Kingdom (UK). Incidental CCA occurs rarely in some patients undergoing LT. We report on retrospective outcomes of patients with incidental CCA from six UK LT centres. Cases were identified from patho...

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Autores principales: Safdar, Nawaz Z., Hakeem, Abdul R., Faulkes, Rosemary, James, Fiona, Mason, Lisa, Masson, Steven, Powell, James, Rowe, Ian, Shetty, Shishir, Jones, Rebecca, Spiers, Harry V. M., Halliday, Neil, Baker, Jack, Thorburn, Douglas, Prasad, Raj, Parker, Richard
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9667791/
https://www.ncbi.nlm.nih.gov/pubmed/36406780
http://dx.doi.org/10.3389/ti.2022.10802
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author Safdar, Nawaz Z.
Hakeem, Abdul R.
Faulkes, Rosemary
James, Fiona
Mason, Lisa
Masson, Steven
Powell, James
Rowe, Ian
Shetty, Shishir
Jones, Rebecca
Spiers, Harry V. M.
Halliday, Neil
Baker, Jack
Thorburn, Douglas
Prasad, Raj
Parker, Richard
author_facet Safdar, Nawaz Z.
Hakeem, Abdul R.
Faulkes, Rosemary
James, Fiona
Mason, Lisa
Masson, Steven
Powell, James
Rowe, Ian
Shetty, Shishir
Jones, Rebecca
Spiers, Harry V. M.
Halliday, Neil
Baker, Jack
Thorburn, Douglas
Prasad, Raj
Parker, Richard
author_sort Safdar, Nawaz Z.
collection PubMed
description Cholangiocarcinoma (CCA) is currently a contraindication to liver transplantation (LT) in the United Kingdom (UK). Incidental CCA occurs rarely in some patients undergoing LT. We report on retrospective outcomes of patients with incidental CCA from six UK LT centres. Cases were identified from pathology records. Data regarding tumour characteristics and post-transplant survival were collected. CCA was classified by TNM staging and anatomical location. 95 patients who underwent LT between 1988–2020 were identified. Median follow-up after LT was 2.1 years (14 days-18.6 years). Most patients were male (68.4%), median age at LT was 53 (IQR 46-62), and the majority had underlying PSC (61%). Overall median survival after LT was 4.4 years. Survival differed by tumour site: 1-, 3-, and 5-year estimated survival was 82.1%, 68.7%, and 57.1%, respectively, in intrahepatic CCA (n = 40) and 58.5%, 42.6%, and 30.2% in perihilar CCA (n = 42; p = 0.06). 1-, 3-, and 5-year estimated survival was 95.8%, 86.5%, and 80.6%, respectively, in pT1 tumours (28.2% of cohort), and 65.8%, 44.7%, and 31.1%, respectively, in pT2-4 (p = 0.018). Survival after LT for recipients with incidental CCA is inferior compared to usual outcomes for LT in the United Kingdom. LT for earlier stage CCA has similar survival to LT for hepatocellular cancer, and intrahepatic CCAs have better survival compared to perihilar CCAs. These observations may support LT for CCA in selected cases.
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spelling pubmed-96677912022-11-17 Outcomes After Liver Transplantation With Incidental Cholangiocarcinoma Safdar, Nawaz Z. Hakeem, Abdul R. Faulkes, Rosemary James, Fiona Mason, Lisa Masson, Steven Powell, James Rowe, Ian Shetty, Shishir Jones, Rebecca Spiers, Harry V. M. Halliday, Neil Baker, Jack Thorburn, Douglas Prasad, Raj Parker, Richard Transpl Int Health Archive Cholangiocarcinoma (CCA) is currently a contraindication to liver transplantation (LT) in the United Kingdom (UK). Incidental CCA occurs rarely in some patients undergoing LT. We report on retrospective outcomes of patients with incidental CCA from six UK LT centres. Cases were identified from pathology records. Data regarding tumour characteristics and post-transplant survival were collected. CCA was classified by TNM staging and anatomical location. 95 patients who underwent LT between 1988–2020 were identified. Median follow-up after LT was 2.1 years (14 days-18.6 years). Most patients were male (68.4%), median age at LT was 53 (IQR 46-62), and the majority had underlying PSC (61%). Overall median survival after LT was 4.4 years. Survival differed by tumour site: 1-, 3-, and 5-year estimated survival was 82.1%, 68.7%, and 57.1%, respectively, in intrahepatic CCA (n = 40) and 58.5%, 42.6%, and 30.2% in perihilar CCA (n = 42; p = 0.06). 1-, 3-, and 5-year estimated survival was 95.8%, 86.5%, and 80.6%, respectively, in pT1 tumours (28.2% of cohort), and 65.8%, 44.7%, and 31.1%, respectively, in pT2-4 (p = 0.018). Survival after LT for recipients with incidental CCA is inferior compared to usual outcomes for LT in the United Kingdom. LT for earlier stage CCA has similar survival to LT for hepatocellular cancer, and intrahepatic CCAs have better survival compared to perihilar CCAs. These observations may support LT for CCA in selected cases. Frontiers Media S.A. 2022-11-02 /pmc/articles/PMC9667791/ /pubmed/36406780 http://dx.doi.org/10.3389/ti.2022.10802 Text en Copyright © 2022 Safdar, Hakeem, Faulkes, James, Mason, Masson, Powell, Rowe, Shetty, Jones, Spiers, Halliday, Baker, Thorburn, Prasad and Parker. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Health Archive
Safdar, Nawaz Z.
Hakeem, Abdul R.
Faulkes, Rosemary
James, Fiona
Mason, Lisa
Masson, Steven
Powell, James
Rowe, Ian
Shetty, Shishir
Jones, Rebecca
Spiers, Harry V. M.
Halliday, Neil
Baker, Jack
Thorburn, Douglas
Prasad, Raj
Parker, Richard
Outcomes After Liver Transplantation With Incidental Cholangiocarcinoma
title Outcomes After Liver Transplantation With Incidental Cholangiocarcinoma
title_full Outcomes After Liver Transplantation With Incidental Cholangiocarcinoma
title_fullStr Outcomes After Liver Transplantation With Incidental Cholangiocarcinoma
title_full_unstemmed Outcomes After Liver Transplantation With Incidental Cholangiocarcinoma
title_short Outcomes After Liver Transplantation With Incidental Cholangiocarcinoma
title_sort outcomes after liver transplantation with incidental cholangiocarcinoma
topic Health Archive
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9667791/
https://www.ncbi.nlm.nih.gov/pubmed/36406780
http://dx.doi.org/10.3389/ti.2022.10802
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