Conflict of interest: None.
Living vs. deceased donor liver transplantation for hepatocellular carcinoma: a systematic review and meta-analysis
Article first published online: 15 NOV 2012
© 2012 John Wiley & Sons A/S
Volume 27, Issue 1, pages 140–147, January–February 2013
How to Cite
Living vs. deceased donor liver transplantation for hepatocellular carcinoma: a systematic review and meta-analysis., , , , , .
- Issue published online: 28 JAN 2013
- Article first published online: 15 NOV 2012
- Manuscript Accepted: 6 AUG 2012
- hepatocellular carcinoma;
- liver transplantation;
Experimental studies suggest that the regenerating liver provides a “fertile field” for the growth of hepatocellular carcinoma (HCC). However, clinical studies report conflicting results comparing living donor liver transplantation (LDLT) and deceased donor liver transplantation (DDLT) for HCC. Thus, disease-free survival (DFS) and overall survival (OS) were compared after LDLT and DDLT for HCC in a systematic review and meta-analysis. Twelve studies satisfied eligibility criteria for DFS, including 633 LDLT and 1232 DDLT. Twelve studies satisfied eligibility criteria for OS, including 637 LDLT and 1050 DDLT. Altogether, there were 16 unique studies; 1, 2, and 13 of these were rated as high, medium, and low quality, respectively. Studies were heterogeneous, non-randomized, and mostly retrospective. The combined hazard ratio was 1.59 (95% confidence interval [CI]: 1.02–2.49; I2 = 50.07%) for DFS after LDLT vs. DDLT for HCC, and 0.97 (95% CI: 0.73–1.27; I2 = 5.68%) for OS. This analysis provides evidence of lower DFS after LDLT compared with DDLT for HCC. Improved study design and reporting is required in future research to ascribe the observed difference in DFS to study bias or biological risk specifically associated with LDLT.