Annals of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회지)

The Korean Association of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회)
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Outcomes of liver transplantation for hepatocellular carcinoma: Experiences from a Vietnamese center

  • Khai Viet Ninh (Organ Transplantation Center, Viet Duc University Hospital) ;
  • Dang Hai Do (Organ Transplantation Center, Viet Duc University Hospital) ;
  • Trung Duc Nguyen (Department of General Surgery, Hanoi Medical University) ;
  • Phuong Ha Tran (Organ Transplantation Center, Viet Duc University Hospital) ;
  • Tuan Hoang (Organ Transplantation Center, Viet Duc University Hospital) ;
  • Dung Thanh Le (Medical Imaging & Nuclear Medicine Center, Viet Duc University Hospital) ;
  • Nghia Quang Nguyen (Organ Transplantation Center, Viet Duc University Hospital)
  • Received : 2023.06.12
  • Accepted : 2023.09.27
  • Published : 2024.02.29
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Abstract

Backgrounds/Aims: Liver transplantation (LT) provides a favorable outcome for patients with hepatocellular carcinoma (HCC) and was launched in Vietnam in 2004. In this study, we evaluated the short-term and long-term outcomes of LT and its risk factors. Methods: This retrospective study analyzed HCC patients who underwent LT at Viet Duc University hospital, Vietnam, from 01/2012-03/2022. The following data were gathered: demographics, virus infection, tumor characteristics, alpha-fetoprotein (AFP) level, Child-Pugh and MELD scores, selection criteria, type of LT, complications, 30-day mortality, and disease-free and overall survival (DFS and OS). Results: Fifty four patients were included, the mean age was 55.39 ± 8.46 years. Nearly 90% had hepatitis B virus-related HCC. The median (interquartile range) AFP level was 16.2 (88.7) ng/mL. The average MELD score was 10.57 ± 5.95; the rate of Child-Pugh A and B were 70.4% and 18.5%, respectively. Nearly 40% of the patients were within Milan criteria, brain-dead donor was 83.3%. Hepatic and portal vein thrombosis occurred in 0% and 1.9%, respectively; hepatic artery thrombosis 1.9%, biliary leakage 5.6%, and postoperative hemorrhage 3.7%. Ninety-day mortality was 5.6%. Five-year DFS and OS were 79.3% and 81.4%, respectively. MELD score and ChildPugh score were predictive factors for DFS and OS (p < 0.05). In multivariate analysis, Child-Pugh score was the only significant factor (p < 0.05). Conclusions: In Vietnam, LT is an effective therapy for HCC with an acceptable complication rate, mortality rate, and good survival outcomes, and should be further encouraged.

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