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Liver Transplantation for Hepatocellular Carcinoma: A Narrative Review and A Glimpse into The Future. | LitMetric

AI Article Synopsis

  • Liver transplantation (LT) is a successful treatment for select patients with hepatocellular carcinoma (HCC), with emphasis on evolving selection criteria and organ allocation policies that help predict patient survival before and after the procedure.
  • Biomarkers like serum alpha-fetoprotein and circulating tumor DNA play a crucial role in anticipating outcomes, while advancements in targeted therapies and immunotherapy are being considered for integration with LT.
  • The review also highlights the increase in living donor liver transplants, improvements in machine perfusion techniques to enhance donor organ usage, and the potential to refine LT strategies and patient selection for better survival rates.

Article Abstract

Liver transplantation (LT) is a highly effective treatment for carefully selected patients with hepatocellular carcinoma (HCC). In this review, we explored the development of LT selection criteria and organ allocation policies, comparing original data to underscore their historical progression into the intricate task of quantitatively estimating pre- and post-LT survivals. We emphasized the role of biomarkers such as serum alpha-fetoprotein, Des-gamma-carboxy-prothrombin, circulating tumor cells, and circulating tumor DNA in predicting patient outcomes. Additionally, we examined the transplant-associated survival benefits and the difficulties in accurately calculating these benefits. We also reviewed recent advancements in targeted therapy and checkpoint inhibitors for advanced, inoperable HCC and projected their integration into LT for HCC. We further discussed the growing use of living donor liver transplants in the United States and compared its outcomes with those of deceased donor liver transplants. Furthermore, we examined the progress in machine perfusion techniques, which have shown potential in improving patient outcomes and enlarging the donor pool. These advancements present opportunities to enhance LT patient survivals, refine selection criteria, establish new priority metrics, develop innovative bridging and downstaging strategies, and formulate redesigned LT strategies for HCC treatments.

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Source
http://dx.doi.org/10.1055/a-2242-7543DOI Listing

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