• Annals of surgery · Apr 2023

    Multicenter Study

    The Effect of a Liver Transplant Program on the Outcomes of Resectable Hepatocellular Carcinoma: A Nationwide Multicenter Analysis.

    • Matteo Serenari, Jacopo Lenzi, Alessandro Cucchetti, Federica Cipriani, Matteo Donadon, Francesco Ardito, Federico Fazio, Daniele Nicolini, Maurizio Iaria, Simone Famularo, Pasquale Perri, Luca Ansaloni, Matteo Zanello, Quirino Lai, Simone Conci, Sarah Molfino, Cecilia Ferrari, Paola Germani, Mauro Zago, Maurizio Romano, Giuseppe Zimmitti, Adelmo Antonucci, Luca Fumagalli, Albert Troci, Valentina Ferraro, Riccardo Memeo, Michele Crespi, Marco Chiarelli, Giorgio Ercolani, Mohamed A Hilal, Giacomo Zanus, Enrico Pinotti, Paola Tarchi, Guido Griseri, Gian Luca Baiocchi, Andrea Ruzzenente, Massimo Rossi, Elio Jovine, Marcello Maestri, Gian Luca Grazi, Fabrizio Romano, Raffaele Dalla Valle, Matteo Ravaioli, Marco Vivarelli, Alessandro Ferrero, Felice Giuliante, Guido Torzilli, Luca Aldrighetti, Matteo Cescon, and HE.RC.O.LE.S. Group.
    • General Surgery and Transplant Unit, IRCCS, Azienda Ospedaliero-Universitaria di Bologna, Sant'Orsola-Malpighi Hospital, Bologna, Italy.
    • Ann. Surg. 2023 Apr 1; 277 (4): 664671664-671.

    ObjectiveTo evaluate the effect of a liver transplantation (LT) program on the outcomes of resectable hepatocellular carcinoma (HCC).BackgroundSurgical treatment of HCC includes both hepatic resection (HR) and LT. However, the presence of cirrhosis and the possibility of recurrence make the management of this disease complex and probably different according to the presence of a LT program.MethodsPatients undergoing HR for HCC between January 2005 and December 2019 were identified from a national database of HCC. The main study outcomes were major surgical complications according to the Comprehensive Complication Index, posthepatectomy liver failure (PHLF), 90-day mortality, overall survival, and disease-free survival. Secondary outcomes were salvage liver transplantation (SLT) and postrecurrence survival.ResultsA total of 3202 patients were included from 25 hospitals over the study period. Three of 25 (12%) had an LT program. The presence of an LT program within a center was associated with a reduced probability of PHLF (odds ratio=0.38) but not with overall survival and disease-free survival. There was an increased probability of SLT when HR was performed in a transplant hospital (odds ratio=12.05). Among transplant-eligible patients, those who underwent LT had a significantly longer postrecurrence survival.ConclusionsThis study showed that the presence of a LT program was associated with decreased PHLF rates and an increased probability to receive SLT in case of recurrence.Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

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