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Related Concept Videos

Tissue Transplantation01:24

Tissue Transplantation

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Tissue transplantation is a significant medical procedure involving the transfer of cells, tissues, or organs from a donor to a recipient, with the primary aim of restoring lost functions. This procedure is crucial in treating a broad spectrum of diseases, including kidney diseases, liver failure, heart disease, and certain types of cancers.
The Biology of Tissue Transplantation
The biology of tissue transplantation hinges on the Major Histocompatibility Complex (MHC) molecules. These molecules...
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Comparative analysis of patients transplanted due to hepatocellular carcinoma. Are there survival differences between

M H Mohamed-Chairi1, A B Vico-Arias2, N Zambudio-Carroll2

  • 1Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Virgen de las Nieves, Granada, Spain; Instituto de Investigación Biosanitaria IBS, Granada, Spain.

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|April 20, 2025
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Summary

Patients exceeding Milan criteria for liver transplant had lower disease-free survival but similar overall survival. Locoregional therapies for hepatocellular carcinoma downstaging showed comparable overall survival outcomes.

Keywords:
Carcinoma hepatocelularCriterios de MilánHepatocellular carcinomaLiver transplantationLocoregional therapyMilan criteriaSupervivenciaSurvivalTerapia locorregionalTrasplante hepático

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Area of Science:

  • Hepatology
  • Transplant Surgery
  • Oncology

Background:

  • The Milan criteria are restrictive for liver transplantation in hepatocellular carcinoma (HCC) patients.
  • Expansion of criteria and downstaging via locoregional therapies are explored to increase transplant eligibility.
  • This study evaluates outcomes for HCC patients meeting versus exceeding Milan criteria post-transplant.

Purpose of the Study:

  • To compare overall and disease-free survival in liver transplant recipients with HCC based on adherence to Milan criteria.
  • To assess the impact of exceeding Milan criteria on transplant outcomes.
  • To analyze the efficacy of locoregional therapies in downstaging patients for HCC transplant.

Main Methods:

  • Retrospective, single-center study of 96 HCC liver transplantations (2010-2021).
  • Analysis of demographic, clinical variables, overall survival, and disease-free survival.
  • Statistical analysis included t-tests, Mann-Whitney U, Fisher's exact, Kaplan-Meier, and log-rank tests.

Main Results:

  • 18 of 96 patients exceeded Milan criteria, presenting with more nodules, larger lesions, and higher bilobar HCC rates.
  • No significant difference in overall survival was observed between groups.
  • Patients exceeding Milan criteria showed a lower disease-free survival rate.

Conclusions:

  • Downstaged HCC patients receiving locoregional therapies had reduced disease-free survival compared to those within Milan criteria.
  • Overall survival remains comparable between groups regardless of meeting Milan criteria.
  • Findings suggest careful consideration of expanded criteria and downstaging strategies for HCC liver transplantation.