18297431

Source:http://linkedlifedata.com/resource/pubmed/id/18297431

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Predicate	Object
rdf:type	pubmed:Citation
lifeskim:mentions	umls-concept:C0015219, umls-concept:C0016884, umls-concept:C0023911, umls-concept:C2239176
pubmed:issue	1
pubmed:dateCreated	2008-2-25
pubmed:abstractText	Over the past quarter-century, liver transplantation (LT) has been established as a durable therapy for all forms of end-stage liver disease. LT appears ideally suited for hepatocellular carcinoma (HCC), as it involves complete oncologic resection and correction of the underlying liver dysfunction. Since LT based on the Milan criteria has been shown to provide good disease-free survival, LT is considered the optimal treatment for small HCC, especially in patients with underlying chronic liver disease. However, because there is a severe shortage of organ donors, not all patients in need can be offered LT. Transplant listing criteria must simultaneously determine the greatest number of suitable candidates for LT while rejecting the smallest number of those who could benefit from LT. The amended model for end-stage liver disease allocation policy has had a positive effect on liver transplant candidates with HCC, and their number has been increasing significantly over the past several years. To minimize dropout from the waiting list, the treatment of HCC with procedures such as chemoembolization, radiofrequency ablation, or ethanol injection in patients awaiting LT have become widespread. It is currently accepted that liver resection is the best option for the treatment of small HCC when liver function is well preserved, and that LT is preferred when liver function is severely impaired (Child-Pugh class B or C). However, the question arises as to what is the best option for Child-Pugh class A patients with early HCC eligible for both resection and LT, especially in Western countries. HCC is a major indication for living donor liver transplantation (LDLT), because the risk of dropout while waiting is negligible. Extension of the Milan criteria in the setting of LDLT may offer more patients a potentially curative treatment without reducing the donor pool of organs for patients on the waiting list with nonmalignant liver disease. However, imprudent expansion of the selection criteria may result in more patients with HCC being cured at the expense of a higher incidence of recurrence.
pubmed:language	eng
pubmed:journal	http://linkedlifedata.com/resource/pubmed/journal/9430794
pubmed:citationSubset	IM
pubmed:status	MEDLINE
pubmed:issn	0944-1174
pubmed:author	pubmed-author:IshizakiYoichiY, pubmed-author:KawasakiSeijiS
pubmed:issnType	Print
pubmed:volume	43
pubmed:owner	NLM
pubmed:authorsComplete	Y
pubmed:pagination	18-26
pubmed:meshHeading	pubmed-meshheading:18297431-Carcinoma, Hepatocellular, pubmed-meshheading:18297431-Humans, pubmed-meshheading:18297431-Liver Neoplasms, pubmed-meshheading:18297431-Liver Transplantation
pubmed:year	2008
pubmed:articleTitle	The evolution of liver transplantation for hepatocellular carcinoma (past, present, and future).
pubmed:affiliation	Department of Hepatobiliary-Pancreatic Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
pubmed:publicationType	Journal Article, Review