Advertisement

Digestive Diseases and Sciences

, Volume 64, Issue 4, pp 993–1000 | Cite as

Living Donor Liver Transplantation for Hepatocellular Carcinoma: An Asian Perspective

  • Young-In YoonEmail author
  • Sung-Gyu LeeEmail author
Review

Abstract

Despite advancements in early diagnosis and medico-surgical treatment, hepatocellular carcinoma (HCC) is still a major cancer that causes substantial mortality in Asian countries. Liver transplantation (LT) has been accepted worldwide as the most effective treatment modality for patients with HCC; however, with the high incidence of HCC and low organ donation rate, Asia has developed distinctive features of indications and strategies for the application of LT. Unlike Western countries, living donor liver transplantation (LDLT) accounts for most LT cases for HCC in Asian countries, and most major transplantation centers perform LDLT for HCC patients with extended criteria. This article reviewed the current practice and outcome of LDLT for HCC from an Asian perspective and summarized the strategies that the high-volume LT centers in Asia use to obtain satisfactory oncologic results.

Keywords

Living donors Liver transplantation Hepatocellular carcinoma Asia 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants performed by any of the authors.

Informed consent

For this type of study, formal consent is not required.

References

  1. 1.
    Forner A, Llovet JM, Bruix J. Hepatocellular carcinoma. Lancet. 2012;379:1245–1255.CrossRefGoogle Scholar
  2. 2.
    Yuen MF, Hou JL, Chutaputti A. Hepatocellular carcinoma in the Asia pacific region. J Gastroenterol Hepatol. 2009;24:346–353.CrossRefGoogle Scholar
  3. 3.
    Llovet JM, Bruix J. Novel advancements in the management of hepatocellular carcinoma in 2008. J Hepatol. 2008;48:S20–37.CrossRefGoogle Scholar
  4. 4.
    Omata M, Cheng AL, Kokudo N, et al. Asia-Pacific clinical practice guidelines on the management of hepatocellular carcinoma: a 2017 update. Hepatol Int. 2017;11:317–370.CrossRefGoogle Scholar
  5. 5.
    Song TJ, Ip EW, Fong Y. Hepatocellular carcinoma: current surgical management. Gastroenterology. 2004;127:S248–260.CrossRefGoogle Scholar
  6. 6.
    Sapisochin G, Bruix J. Liver transplantation for hepatocellular carcinoma: outcomes and novel surgical approaches. Nat Rev Gastroenterol Hepatol. 2017;14:203–217.CrossRefGoogle Scholar
  7. 7.
    de Villa V, Lo CM. Liver transplantation for hepatocellular carcinoma in Asia. Oncologist. 2007;12:1321–1331.CrossRefGoogle Scholar
  8. 8.
    Hwang S, Lee SG, Belghiti J. Liver transplantation for HCC: its role: Eastern and Western perspectives. J Hepatobiliary Pancreat Sci. 2010;17:443–448.CrossRefGoogle Scholar
  9. 9.
    Akamatsu N, Sugawara Y, Kokudo N. Living donor liver transplantation for patients with hepatocellular carcinoma. Liver Cancer. 2014;3:108–118.CrossRefGoogle Scholar
  10. 10.
    Lee HW, Suh KS. Expansion of the criteria for living donor liver transplantation for hepatocellular carcinoma. Curr Opin Organ Transpl. 2016;21:231–237.CrossRefGoogle Scholar
  11. 11.
    Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer. 2010;127:2893–2917.CrossRefGoogle Scholar
  12. 12.
    McGlynn KA, London WT. Epidemiology and natural history of hepatocellular carcinoma. Best Pract Res Clin Gastroenterol. 2005;19:3–23.CrossRefGoogle Scholar
  13. 13.
    Asia-Pacific Working Party on Prevention of Hepatocellular Carcinoma. Prevention of hepatocellular carcinoma in the Asia-Pacific region: consensus statements. J Gastroenterol Hepatol. 2010;25:657–663.CrossRefGoogle Scholar
  14. 14.
    Chan SC. Liver transplantation for hepatocellular carcinoma. Liver Cancer. 2013;2:338–344.CrossRefGoogle Scholar
  15. 15.
    Shukla A, Vadeyar H, Rela M, Shah S. Liver transplantation: East versus West. J Clin Exp Hepatol. 2013;3:243–253.CrossRefGoogle Scholar
  16. 16.
    Lee SG. A complete treatment of adult living donor liver transplantation: a review of surgical technique and current challenges to expand indication of patients. Am J Transpl. 2015;15:17–38.CrossRefGoogle Scholar
  17. 17.
    Xu DW, Wan P, Xia Q. Liver transplantation for hepatocellular carcinoma beyond the Milan criteria: a review. World J Gastroenterol. 2016;22:3325–3334.CrossRefGoogle Scholar
  18. 18.
    Pinheiro RS, Waisberg DR, Nacif LS, et al. Living donor liver transplantation for hepatocellular cancer: an (almost) exclusive Eastern procedure? Transl Gastroenterol Hepatol. 2017;2:68.CrossRefGoogle Scholar
  19. 19.
    Ng KK, Lo CM, Chan SC, Chok KS, Cheung TT, Fan ST. Liver transplantation for hepatocellular carcinoma: the Hong Kong experience. J Hepatobiliary Pancreat Sci. 2010;17:548–554.CrossRefGoogle Scholar
  20. 20.
    Sugawara Y, Tamura S, Makuuchi M. Living donor liver transplantation for hepatocellular carcinoma: Tokyo University series. Dig Dis. 2007;25:310–312.CrossRefGoogle Scholar
  21. 21.
    Lee SG, Hwang S, Moon DB, et al. Expanded indication criteria of living donor liver transplantation for hepatocellular carcinoma at one large-volume center. Liver Transpl. 2008;14:935–945.CrossRefGoogle Scholar
  22. 22.
    Kaido T, Ogawa K, Mori A, et al. Usefulness of the Kyoto criteria as expanded selection criteria for liver transplantation for hepatocellular carcinoma. Surgery. 2013;154:1053–1060.CrossRefGoogle Scholar
  23. 23.
    Uchiyama H, Itoh S, Yoshizumi T, et al. Living donor liver transplantation for hepatocellular carcinoma: results of prospective patient selection by Kyushu University Criteria in 7 years. HPB (Oxford). 2017;19:1082–1090.CrossRefGoogle Scholar
  24. 24.
    Kim JM, Kwon CH, Joh JW, et al. Expanded criteria for liver transplantation in patients with hepatocellular carcinoma. Transpl Proc. 2014;46:726–729.CrossRefGoogle Scholar
  25. 25.
    Lee SD, Lee B, Kim SH, et al. Proposal of new expanded selection criteria using total tumor size and (18)F-fluorodeoxyglucose—positron emission tomography/computed tomography for living donor liver transplantation in patients with hepatocellular carcinoma: The National Cancer Center Korea criteria. World J Transpl. 2016;6:411–422.CrossRefGoogle Scholar
  26. 26.
    Toso C, Trotter J, Wei A, et al. Total tumor volume predicts risk of recurrence following liver transplantation in patients with hepatocellular carcinoma. Liver Transpl. 2008;14:1107–1115.CrossRefGoogle Scholar
  27. 27.
    Toso C, Asthana S, Bigam DL, Shapiro AM, Kneteman NM. Reassessing selection criteria prior to liver transplantation for hepatocellular carcinoma utilizing the Scientific Registry of Transplant Recipients database. Hepatology. 2009;49:832–838.CrossRefGoogle Scholar
  28. 28.
    Majno P, Giostra E, Mentha G. Management of hepatocellular carcinoma on the waiting list before liver transplantation: time for controlled trials? Liver Transpl. 2007;13:S27–35.CrossRefGoogle Scholar
  29. 29.
    Edwards E, Harper A, Freeman R. The effect of pre-transplant ablation therapy on post-transplant outcome in liver recipients with hepatocellular carcinoma. Am J Transpl. 2008;8:267.CrossRefGoogle Scholar
  30. 30.
    Sharr WW, Chan SC, Lo CM. Section 3. Current status of downstaging of hepatocellular carcinoma before liver transplantation. Transplantation. 2014;97:S10–17.CrossRefGoogle Scholar
  31. 31.
    Kumaran V. Role of liver transplantation for hepatocellular carcinoma. J Clin Exp Hepatol. 2014;4:S97–s103.CrossRefGoogle Scholar
  32. 32.
    Lei J, Yan L. Comparison between living donor liver transplantation recipients who met the Milan and UCSF criteria after successful downstaging therapies. J Gastrointest Surg. 2012;16:2120–2125.CrossRefGoogle Scholar
  33. 33.
    Ahn CS, Moon DB, Lee SG, et al. Survival differences between Milan criteria after down-staging and De novo Milan in living donor liver transplantation for hepatocellular carcinoma. Hepatogastroenterology. 2014;61:187–191.Google Scholar
  34. 34.
    Choi JY, Yu JI, Park HC, et al. The possibility of radiotherapy as downstaging to living donor liver transplantation for hepatocellular carcinoma with portal vein tumor thrombus. Liver Transpl. 2017;23:545–551.CrossRefGoogle Scholar
  35. 35.
    Choi HJ, Kim DG, Na GH, et al. The clinical outcomes of patients with portal vein tumor thrombi after living donor liver transplantation. Liver Transpl. 2017;23:1023–1031.CrossRefGoogle Scholar
  36. 36.
    Han DH, Joo DJ, Kim MS, et al. Living donor liver transplantation for advanced hepatocellular carcinoma with portal vein tumor thrombosis after concurrent chemoradiation therapy. Yonsei Med J. 2016;57:1276–1281.CrossRefGoogle Scholar
  37. 37.
    Jeong Y, Shin MH, Yoon SM, et al. Liver transplantation after transarterial chemoembolization and radiotherapy for hepatocellular carcinoma with vascular invasion. J Gastrointest Surg. 2017;21:275–283.CrossRefGoogle Scholar
  38. 38.
    Ng KK, Lo CM. Liver transplantation in Asia: past, present and future. Ann Acad Med Singapore. 2009;38:322-310.Google Scholar
  39. 39.
    Ikegami T, Taketomi A, Soejima Y, et al. Rituximab, IVIG, and plasma exchange without graft local infusion treatment: a new protocol in ABO incompatible living donor liver transplantation. Transplantation. 2009;88:303–307.CrossRefGoogle Scholar
  40. 40.
    Soejima Y, Muto J, Matono R, et al. Strategic breakthrough in adult ABO-incompatible living donor liver transplantation: preliminary results of consecutive seven cases. Clin Transpl. 2013;27:227–231.CrossRefGoogle Scholar
  41. 41.
    Miyagi S, Kawagishi N, Sekiguchi S, et al. The relationship between recurrences and immunosuppression on living donor liver transplantation for hepatocellular carcinoma. Transpl Proc. 2012;44:797–801.CrossRefGoogle Scholar
  42. 42.
    Rummler S, Bauschke A, Baerthel E, et al. ABO-incompatible living donor liver transplantation in focus of antibody rebound. Transfus Med Hemother. 2017;44:46–51.CrossRefGoogle Scholar
  43. 43.
    Yoon YI, Song GW, Lee SG, et al. Outcome of ABO-incompatible adult living-donor liver transplantation for patients with hepatocellular carcinoma. J Hepatol. 2018;68:1153–1162.CrossRefGoogle Scholar
  44. 44.
    Kim JM, Kwon CHD, Joh JW, et al. ABO-incompatible living donor liver transplantation with rituximab and total plasma exchange does not increase hepatocellular carcinoma recurrence. Transplantation. 2018;102:1695–1701.CrossRefGoogle Scholar
  45. 45.
    Lo CM, Fan ST, Liu CL, Chan SC, Ng IO, Wong J. Living donor versus deceased donor liver transplantation for early irresectable hepatocellular carcinoma. Br J Surg. 2007;94:78–86.CrossRefGoogle Scholar
  46. 46.
    Kim BW, Park YK, Kim YB, Wang HJ, Kim MW. Salvage liver transplantation for recurrent hepatocellular carcinoma after liver resection: feasibility of the Milan criteria and operative risk. Transpl Proc. 2008;40:3558–3561.CrossRefGoogle Scholar
  47. 47.
    Hwang S, Lee SG, Moon DB, et al. Salvage living donor liver transplantation after prior liver resection for hepatocellular carcinoma. Liver Transpl. 2007;13:741–746.CrossRefGoogle Scholar
  48. 48.
    Hu Z, Zhou J, Li Z, et al. Salvage liver transplantation for recurrent hepatocellular carcinoma after liver resection: retrospective study of the Milan and Hangzhou criteria. PLoS One. 2014;9:e87222.CrossRefGoogle Scholar
  49. 49.
    Chan SC. Section 2. Small-for-size liver graft and hepatocellular carcinoma recurrence. Transplantation. 2014;97:S7–s10.CrossRefGoogle Scholar
  50. 50.
    Pang TC, Lam VW. Surgical management of hepatocellular carcinoma. World J Hepatol. 2015;7:245–252.CrossRefGoogle Scholar
  51. 51.
    Park GC, Song GW, Moon DB, Lee SG. A review of current status of living donor liver transplantation. Hepatobiliary Surg Nutr. 2016;5:107–117.Google Scholar
  52. 52.
    Moon DB, Lee SG, Hwang S, et al. No-touch en bloc right lobe living-donor liver transplantation with inferior vena cava replacement for hepatocellular carcinoma close to retrohepatic inferior vena cava: case report. Transpl Proc. 2013;45:3135–3139.CrossRefGoogle Scholar
  53. 53.
    Todo S, Furukawa H. Living donor liver transplantation for adult patients with hepatocellular carcinoma: experience in Japan. Ann Surg. 2004;240:451–459. (discussion 459–461).CrossRefGoogle Scholar
  54. 54.
    Hwang S, Lee SG, Joh JW, Suh KS, Kim DG. Liver transplantation for adult patients with hepatocellular carcinoma in Korea: comparison between cadaveric donor and living donor liver transplantations. Liver Transpl. 2005;11:1265–1272.CrossRefGoogle Scholar
  55. 55.
    Toso C, Meeberg GA, Bigam DL, et al. De novo sirolimus-based immunosuppression after liver transplantation for hepatocellular carcinoma: long-term outcomes and side effects. Transplantation. 2007;83:1162–1168.CrossRefGoogle Scholar
  56. 56.
    Cholongitas E, Mamou C, Rodriguez-Castro KI, Burra P. Mammalian target of rapamycin inhibitors are associated with lower rates of hepatocellular carcinoma recurrence after liver transplantation: a systematic review. Transpl Int. 2014;27:1039–1049.CrossRefGoogle Scholar
  57. 57.
    Rahimi RS, Trotter JF. Liver transplantation for hepatocellular carcinoma: outcomes and treatment options for recurrence. Ann Gastroenterol. 2015;28:323–330.Google Scholar
  58. 58.
    Huang L, Li GM, Zhu JY, Li Z, Li T, Leng XS. Efficacy of sorafenib after liver transplantation in patients with primary hepatic carcinoma exceeding the Milan criteria: a preliminary study. Onco Targets Ther. 2012;5:457–462.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulKorea

Personalised recommendations