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Validation Of Japanese Indication Criteria For Deceased Donor Liver Transplantation For Hepatocellular Carcinoma: Analysis Of Us National Registry Data.

Home
Research Domains
Biomedical And Clinical Sciences
Oncology And Carcinogenesis
Predictive And Prognostic Markers
Validation Of Japanese Indication Criteria For Deceased Donor Liver Transplantation For Hepatocellular Carcinoma: Analysis Of Us National Registry Data.

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Validation of Japanese indication criteria for deceased donor liver transplantation for hepatocellular carcinoma: Analysis of US national registry data.

Yuki Bekki¹, Shinji Itoh¹, Takeo Toshima¹

¹Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

Hepatology Research : the Official Journal of the Japan Society of Hepatology

|February 3, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

Keywords:

5‐5‐500 rule HCC Milan criteria liver transplantation

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The 5-5-500 rule aids in selecting patients for deceased donor liver transplantation (DDLT) for liver cancer. However, elevated alpha-fetoprotein levels between 300-500 ng/mL indicate poorer outcomes, warranting further study.

Area of Science:

Hepatology
Transplant Surgery
Oncology

Background:

Liver transplantation (LT) criteria for hepatocellular carcinoma (HCC) have evolved, with Japan adopting the Milan criteria (MC) or the 5-5-500 rule.
The 5-5-500 rule includes a nodule size of ≤5 cm, ≤5 nodules, and an alpha-fetoprotein (AFP) level ≤500 ng/mL.
Validation of these criteria for deceased donor LT (DDLT) is crucial for patient selection.

Purpose of the Study:

To validate the 5-5-500 rule and the Milan criteria (MC) for deceased donor liver transplantation (DDLT) in hepatocellular carcinoma (HCC) patients.
To assess the impact of different criteria combinations on patient survival and tumor recurrence.
To evaluate the prognostic significance of specific AFP level strata within the 5-5-500 rule.

Main Methods:

Utilized US national registry data from 2010-2014 for DDLT recipients.

Categorized patients into four groups based on adherence to MC and the 5-5-500 rule.

Stratified AFP values into ≤100, 101-300, 301-500, and >500 ng/mL for survival analysis.

Main Results:

Patients within MC and 5-5-500 criteria had the highest 5-year survival (76.2%).
HCC recurrence at 5 years was lowest (7.4%) in the within MC/within 5-5-500 group.
Survival rates decreased significantly with increasing AFP levels, with 5-year survival at 55.6% for AFP >500 ng/mL and 58.4% for AFP 301-500 ng/mL.

Conclusions:

The 5-5-500 rule is a valuable tool for selecting HCC patients for DDLT.
Patients with AFP levels between 300-500 ng/mL demonstrate inferior outcomes despite meeting 5-5-500 criteria.
Further research is needed to refine treatment strategies for HCC patients with intermediate AFP levels undergoing DDLT.