These authors contributed equally to this work.
Living donor liver transplantation versus deceased donor liver transplantation for hepatocellular carcinoma: A meta-analysis†
Article first published online: 14 OCT 2012
Copyright © 2012 American Association for the Study of Liver Diseases
Volume 18, Issue 10, pages 1226–1236, October 2012
How to Cite
Liang, W., Wu, L., Ling, X., Schroder, P. M., Ju, W., Wang, D., Shang, Y., Kong, Y., Guo, Z. and He, X. (2012), Living donor liver transplantation versus deceased donor liver transplantation for hepatocellular carcinoma: A meta-analysis. Liver Transpl, 18: 1226–1236. doi: 10.1002/lt.23490
This study was supported by the National High Technology Research and Development Program of China through the 863 Program (grant 2012AA021008), the Key Clinical Project of the Chinese Ministry of Health (grant 2010159), the National Natural Science Foundation of China (grants 30972951, 81102244, 81102245, and 81170448), and the Special Fund for Science Research of the Chinese Ministry of Health (grant 201002004).
- Issue published online: 14 OCT 2012
- Article first published online: 14 OCT 2012
- Accepted manuscript online: 9 JUN 2012 08:37AM EST
- Manuscript Accepted: 3 JUN 2012
- Manuscript Received: 6 JAN 2012
- National High Technology Research
- Development Program of China. Grant Number: 2012AA021008
- Key Clinical Project of the Chinese Ministry of Health. Grant Number: 2010159
- National Natural Science Foundation of China. Grant Numbers: 30972951, 81102244, 81102245, 81170448
- Special Fund for Science Research of the Chinese Ministry of Health. Grant Number: 201002004
Because of the severe organ shortage, living donor liver transplantation (LDLT) offers a timely alternative to deceased donor liver transplantation (DDLT) for patients with hepatocellular carcinoma (HCC). However, the higher recurrence rate of HCC after LDLT and the indication criteria remain controversial. By conducting a quantitative meta-analysis, we sought to compare the survival outcomes and recurrence rates with LDLT and DDLT for patients with HCC. Comparative studies of LDLT and DDLT for HCC, which were identified by a comprehensive literature search, were included in this study. The evaluated outcomes included patient survival, recurrence-free survival (RFS), and recurrence rates at defined time points. Seven studies with a total of 1310 participants were included in this study. For LDLT and DDLT recipients, we found comparable patient survival rates [1 year, odds ratio (OR) = 1.03, 95% confidence interval (CI) = 0.62-1.73; 3 years, OR = 1.07, 95% CI = 0.77-1.48; and 5 years, OR = 0.64, 95% CI = 0.33-1.24] and RFS rates (1 year, OR = 0.86, 95% CI = 0.54-1.38; 3 years, OR = 1.04, 95% CI = 0.69-1.58; and 5 years, OR = 1.11, 95% CI = 0.70-1.77). Moreover, we found no significant differences in the 1-, 3-, or 5-year recurrence rates between LDLT and DDLT recipients (1 year, OR = 1.55, 95% CI = 0.36-6.58; 3 years, OR = 2.57, 95% CI = 0.53-12.41; and 5 years, OR = 1.21, 95% CI = 0.44-3.32). A subgroup analysis revealed similar outcomes for patients with HCC meeting the Milan criteria. These findings demonstrate that for HCC patients (especially those within the Milan criteria), LDLT represents an acceptable option that does not compromise patient survival or increase HCC recurrence in comparison with DDLT. Liver Transpl 18:1226–1236, 2012. © 2012 AASLD.