Liver Transplantation for Cancer: The Future of Transplant Oncology

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Transplant Oncology".

Deadline for manuscript submissions: closed (30 April 2024) | Viewed by 3230

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Guest Editor
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka City 812-8582, Fukuoka, Japan
Interests: liver; transplantation; hepatocellular carcinoma; cholangiocellular carcinoma; surgery
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Special Issue Information

Dear Colleagues,

Liver transplantation (LT) for hepatocellular carcinoma (HCC) is a treatment that includes the underlying cirrhosis; theoretically, there is no better treatment. Many studies showed that selected patients with HCC can have improved outcomes after LT. Recently, other hepatobiliary malignancies, such as unresectable perihilar cholangiocarcinoma or liver metastasis for colorectal cancer, have been treated by LT with significant improved outcomes. The concept of such cancer treatment is defined as “transplant oncology”. On the other hand, there are some cautious views that LT for non-HCC malignancies including neuroendocrine tumors should be performed only in high-volume centers under strict selection criteria due to the current shortage of available organs. With this Special Issue, we aim to discuss the selection criteria, pre-LT treatment, appropriate immunosuppressive regimen, and strategies for the follow-up of LT for hepatobiliary malignancies to establish the concept of transplant oncology. 

You may choose our Joint Special Issue in Current Oncology.

Prof. Dr. Tomoharu Yoshizumi
Guest Editor

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Published Papers (2 papers)

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Research

12 pages, 636 KiB  
Article
Early Results of a Screening Program for Skin Cancer in Liver Transplant Recipients: A Cohort Study
by Delal Akdag, Allan Rasmussen, Susanne Dam Nielsen, Dina Leth Møller, Katrine Togsverd-Bo, Emily Wenande, Merete Haedersdal and Hans-Christian Pommergaard
Cancers 2024, 16(6), 1224; https://doi.org/10.3390/cancers16061224 - 20 Mar 2024
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Abstract
(1) Background: Skin cancer is the most common cancer in transplant recipients. Timely and regular screening may reduce advanced disease. The study aimed to determine referral rates to screening, the incidence, and risk factors of skin cancer in a Danish liver transplant recipient [...] Read more.
(1) Background: Skin cancer is the most common cancer in transplant recipients. Timely and regular screening may reduce advanced disease. The study aimed to determine referral rates to screening, the incidence, and risk factors of skin cancer in a Danish liver transplant recipient cohort. (2) Methods: All first-time liver transplant recipients, >18 years old, attending outpatient care between January 2018 and December 2021 were included. The referral rates and incidence of skin cancer/preneoplastic lesions were calculated. Risk factors were assessed using Cox regression analyses. (3) Results: Of the 246 included recipients, 219 (89.0%) were referred to screening, and 102 skin cancer/preneoplastic lesions were diagnosed in 32 (15.6%) recipients. The IR of any skin cancer/preneoplastic lesion was 103.2 per 1000 person-years. BCC was the most frequent skin cancer followed by SCC, IR: 51.3 vs. 27.1 per 1000 person-years, respectively. No cases of MM were observed. The IR of actinic keratosis and Bowen’s Disease were 48.1 vs. 13.2 per 1000 person-years, respectively. Time since transplantation was independently associated with skin cancer/preneoplastic lesions, HR (95%CI) 2.81 (1.64–4.80). (4) Conclusions: The study determined the incidence and risk factors of skin cancer/preneoplastic lesions in liver transplant recipients enrolled in a screening program, while demonstrating a high screening referral rate. Full article
(This article belongs to the Special Issue Liver Transplantation for Cancer: The Future of Transplant Oncology)
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14 pages, 1121 KiB  
Article
Declined Organs for Liver Transplantation: A Right Decision or a Missed Opportunity for Patients with Hepatocellular Carcinoma?
by Vladimir J. Lozanovski, Said Adigozalov, Elias Khajeh, Omid Ghamarnejad, Ehsan Aminizadeh, Christina Schleicher, Thilo Hackert, Beat Peter Müller-Stich, Uta Merle, Susanne Picardi, Frederike Lund, De-Hua Chang, Markus Mieth, Hamidreza Fonouni, Mohammad Golriz and Arianeb Mehrabi
Cancers 2023, 15(5), 1365; https://doi.org/10.3390/cancers15051365 - 21 Feb 2023
Cited by 1 | Viewed by 1592
Abstract
Background: Liver transplantation is the only promising treatment for end-stage liver disease and patients with hepatocellular carcinoma. However, too many organs are rejected for transplantation. Methods: We analyzed the factors involved in organ allocation in our transplant center and reviewed all livers that [...] Read more.
Background: Liver transplantation is the only promising treatment for end-stage liver disease and patients with hepatocellular carcinoma. However, too many organs are rejected for transplantation. Methods: We analyzed the factors involved in organ allocation in our transplant center and reviewed all livers that were declined for transplantation. Reasons for declining organs for transplantation were categorized as major extended donor criteria (maEDC), size mismatch and vascular problems, medical reasons and risk of disease transmission, and other reasons. The fate of the declined organs was analyzed. Results: 1086 declined organs were offered 1200 times. A total of 31% of the livers were declined because of maEDC, 35.5% because of size mismatch and vascular problems, 15.8% because of medical reasons and risk of disease transmission, and 20.7% because of other reasons. A total of 40% of the declined organs were allocated and transplanted. A total of 50% of the organs were completely discarded, and significantly more of these grafts had maEDC than grafts that were eventually allocated (37.5% vs. 17.7%, p < 0.001). Conclusion: Most organs were declined because of poor organ quality. Donor-recipient matching at time of allocation and organ preservation must be improved by allocating maEDC grafts using individualized algorithms that avoid high-risk donor-recipient combinations and unnecessary organ declination. Full article
(This article belongs to the Special Issue Liver Transplantation for Cancer: The Future of Transplant Oncology)
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