Liver transplantation for hepatocellular carcinoma: impact of expansion criteria in a multicenter cohort study from a high waitlist mortality region

Simple item page
dc.contributor.authorPinero, Federico
dc.contributor.authorAnders, Margarita
dc.contributor.authorBoin, Ilka F.
dc.contributor.authorChagas, Aline
dc.contributor.authorQuinonez, Emilio
dc.contributor.authorMarciano, Sebastian
dc.contributor.authorVilatoba, Mario
dc.contributor.authorSantos, Luisa
dc.contributor.authorHoyos Duque, Sergio
dc.contributor.authorLima, Agnaldo Soares
dc.contributor.authorMenendez, Josemaria
dc.contributor.authorPadilla, Martin
dc.contributor.authorPoniachik, Jaime
dc.contributor.authorZapata, Rodrigo
dc.contributor.authorSoza, Alejandro
dc.contributor.authorMaraschio, Martin
dc.contributor.authorChong Menendez, Ricardo
dc.contributor.authorMunoz, Linda
dc.contributor.authorArufe, Diego
dc.contributor.authorFigueroa, Rodrigo
dc.contributor.authorde Ataide, Elaine Cristina
dc.contributor.authorMaccali, Claudia
dc.contributor.authorVergara Sandoval, Rodrigo
dc.contributor.authorBermudez, Carla
dc.contributor.authorPodesta, Luis G.
dc.contributor.authorMcCormack, Lucas
dc.contributor.authorVaron, Adriana
dc.contributor.authorGadano, Adrian
dc.contributor.authorMattera, Juan
dc.contributor.authorVillamil, Federico
dc.contributor.authorRubinstein, Fernando
dc.contributor.authorCarrilho, Flair
dc.contributor.authorSilva, Marcelo
dc.date.accessioned2025-01-20T23:55:27Z
dc.date.available2025-01-20T23:55:27Z
dc.date.issued2021
dc.description.abstractThis study aimed to compare liver transplantation (LT) outcomes and evaluate the potential rise in numbers of LT candidates with hepatocellular carcinoma (HCC) of different allocation policies in a high waitlist mortality region. Three policies were applied in two Latin American cohorts (1085 HCC transplanted patients and 917 listed patients for HCC): (i) Milan criteria with expansion according to UCSF downstaging (UCSF-DS), (ii) the AFP score, and (iii) restrictive policy or Double Eligibility Criteria (DEC; within Milan + AFP score <= 2). Increase in HCC patient numbers was evaluated in an Argentinian prospective validation set (INCUCAI; NCT03775863). Expansion criteria in policy A showed that UCSF-DS [28.4% (CI 12.8-56.2)] or "all-comers" [32.9% (CI 11.9-71.3)] had higher 5-year recurrence rates compared to Milan, with 10.9% increase in HCC patients for LT. The policy B showed lower recurrence rates for AFP scores <= 2 points, even expanding beyond Milan criteria, with a 3.3% increase. Patients within DEC had lower 5-year recurrence rates compared with those beyond DEC [13.3% (CI 10.1-17.3) vs 24.2% (CI 17.4-33.1; P = 0.0006], without significant HCC expansion. In conclusion, although the application of a stricter policy may optimize the selection process, this restrictive policy may lead to ethical concerns in organ allocation (NCT03775863).
dc.fuente.origenWOS
dc.identifier.doi10.1111/tri.13767
dc.identifier.eissn1432-2277
dc.identifier.issn0934-0874
dc.identifier.urihttps://doi.org/10.1111/tri.13767
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/95089
dc.identifier.wosidWOS:000605415100009
dc.issue.numero1
dc.language.isoen
dc.pagina.final109
dc.pagina.inicio97
dc.revistaTransplant international
dc.rightsacceso restringido
dc.subjectallocation
dc.subjecthepatocellular carcinoma
dc.subjectliver transplantation
dc.subjectselection
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleLiver transplantation for hepatocellular carcinoma: impact of expansion criteria in a multicenter cohort study from a high waitlist mortality region
dc.typeartículo
dc.volumen34
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
Files
Collections
Artículos de revistas