An intention-to-treat analysis of liver transplantation for hepatocellular carcinoma using organ procurement transplant network data
dc.contributor.author | Pelletier, Shawn J. | en_US |
dc.contributor.author | Fu, Sherry | en_US |
dc.contributor.author | Thyagarajan, Veena | en_US |
dc.contributor.author | Romero-Marrero, Carlos | en_US |
dc.contributor.author | Batheja, Mashal J. | en_US |
dc.contributor.author | Punch, Jeffrey D. | en_US |
dc.contributor.author | Magee, John C. | en_US |
dc.contributor.author | Lok, Anna Suk-Fong | en_US |
dc.contributor.author | Fontana, Robert John | en_US |
dc.contributor.author | Marrero, Jorge A. | en_US |
dc.date.accessioned | 2009-08-12T15:34:47Z | |
dc.date.available | 2010-10-05T18:27:29Z | en_US |
dc.date.issued | 2009-08 | en_US |
dc.identifier.citation | Pelletier, Shawn J.; Fu, Sherry; Thyagarajan, Veena; Romero-Marrero, Carlos; Batheja, Mashal J.; Punch, Jeffrey D.; Magee, John C.; Lok, Anna S.; Fontana, Robert J.; Marrero, Jorge A. (2009). "An intention-to-treat analysis of liver transplantation for hepatocellular carcinoma using organ procurement transplant network data." Liver Transplantation 15(8): 859-868. <http://hdl.handle.net/2027.42/63540> | en_US |
dc.identifier.issn | 1527-6465 | en_US |
dc.identifier.issn | 1527-6473 | en_US |
dc.identifier.uri | https://hdl.handle.net/2027.42/63540 | |
dc.description.abstract | Single-center studies have shown acceptable long-term outcomes following orthotopic liver transplantation (OLT) for hepatocellular carcinoma (HCC) when tumors are within the Milan criteria. However, the overall survival and waiting list removal rates have not been described at a national level with pooled registry data. To evaluate this, a retrospective cohort of patients listed for OLT with a diagnosis of HCC between January 1998 and March 2006 was identified from Organ Procurement Transplant Network data. Analysis was performed from the time of listing. Adjusted Cox models were used to assess the relative effect of potential confounders on removal from the waiting list as well as survival from the time of wait listing. A total of 4482 patients with HCC were placed on the liver waiting list during the study period. Of these, 65% underwent transplantation, and 18% were removed from the list because of tumor progression or death. The overall 1- and 5-year intent-to-treat survival for all patients listed was 81% and 51%, respectively. The 1- and 5-year survival was 89% and 61% for those listed with tumors meeting the Milan criteria versus 70% and 32% for those exceeding the Milan criteria ( P < 0.0001). On multivariate analysis, advanced liver failure manifested by Child-Pugh class B or C increased the risk of death, while age < 55 years, meeting the Milan criteria, and obtaining a liver transplant were associated with better survival. The current criteria for liver transplantation of candidates with HCC lead to acceptable 5-year survival while limiting the dropout rate. Liver Transpl 15:859–868, 2009. © 2009 AASLD. | en_US |
dc.format.extent | 160445 bytes | |
dc.format.extent | 3118 bytes | |
dc.format.mimetype | application/pdf | |
dc.format.mimetype | text/plain | |
dc.publisher | Wiley Subscription Services, Inc., A Wiley Company | en_US |
dc.subject.other | Life and Medical Sciences | en_US |
dc.subject.other | Surgery | en_US |
dc.title | An intention-to-treat analysis of liver transplantation for hepatocellular carcinoma using organ procurement transplant network data | en_US |
dc.type | Article | en_US |
dc.rights.robots | IndexNoFollow | en_US |
dc.subject.hlbsecondlevel | Surgery and Anesthesiology | en_US |
dc.subject.hlbtoplevel | Health Sciences | en_US |
dc.description.peerreviewed | Peer Reviewed | en_US |
dc.contributor.affiliationum | Division of Transplantation, Department of Surgery, University of Michigan, Ann Arbor, MI ; Division of Gastroenterology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI ; Telephone: 734-936-8363; FAX: 734-763-3187 ; 2922D Taubman Center, 1500 East Medical Center Drive, Ann Arbor, MI 48109-5331 | en_US |
dc.contributor.affiliationum | Division of Gastroenterology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI | en_US |
dc.contributor.affiliationum | Division of Gastroenterology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI | en_US |
dc.contributor.affiliationum | Division of Gastroenterology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI | en_US |
dc.contributor.affiliationum | Division of Gastroenterology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI | en_US |
dc.contributor.affiliationum | Division of Transplantation, Department of Surgery, University of Michigan, Ann Arbor, MI ; Division of Gastroenterology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI | en_US |
dc.contributor.affiliationum | Division of Transplantation, Department of Surgery, University of Michigan, Ann Arbor, MI ; Division of Gastroenterology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI | en_US |
dc.contributor.affiliationum | Division of Gastroenterology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI | en_US |
dc.contributor.affiliationum | Division of Gastroenterology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI | en_US |
dc.contributor.affiliationum | Division of Gastroenterology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI | en_US |
dc.identifier.pmid | 19642139 | en_US |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/63540/1/21778_ftp.pdf | |
dc.identifier.doi | 10.1002/lt.21778 | en_US |
dc.identifier.source | Liver Transplantation | en_US |
dc.owningcollname | Interdisciplinary and Peer-Reviewed |
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