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. 2023 May;30(5):2769-2777.
doi: 10.1245/s10434-023-13147-6. Epub 2023 Jan 31.

The Current State of Liver Transplantation for Colorectal Liver Metastases in the United States: A Call for Standardized Reporting

Kazunari Sasaki  1 , Luis I Ruffolo  2 , Michelle H Kim  3 , Masato Fujiki  4 , Koji Hashimoto  4 , Yuki Imaoka  3 , Marc L Melcher  3 , Federico N Aucejo  4 , Koji Tomiyama  2 , Roberto Hernandez-Alejandro  2
Affiliations

The Current State of Liver Transplantation for Colorectal Liver Metastases in the United States: A Call for Standardized Reporting

Kazunari Sasaki et al. Ann Surg Oncol. 2023 May.

Abstract

Background: Current success in transplant oncology for select liver tumors, such as hepatocellular carcinoma, has ignited international interest in liver transplantation (LT) as a therapeutic option for nonresectable colorectal liver metastases (CRLM). In the United States, the CRLM LT experience is limited to reports from a handful of centers. This study was designed to summarize donor, recipient, and transplant center characteristics and posttransplant outcomes for the indication of CRLM.

Methods: Adult, primary LT patients listed between December 2017 and March 2022 were identified by using United Network Organ Sharing database. LT for CRLM was identified from variables: "DIAG_OSTXT"; "DGN_OSTXT_TCR"; "DGN2_OSTXT_TCR"; and "MALIG_TY_OSTXT."

Results: During this study period, 64 patients were listed, and 46 received LT for CRLM in 15 centers. Of 46 patients who underwent LT for CRLM, 26 patients (56.5%) received LTs using living donor LT (LDLT), and 20 patients received LT using deceased donor (DDLT) (43.5%). The median laboratory MELD-Na score at the time of listing was statistically similar between the LDLT and DDLT groups (8 vs. 9, P = 0.14). This persisted at the time of LT (8 vs. 12, P = 0.06). The 1-, 2-, and 3-year, disease-free, survival rates were 75.1, 53.7, and 53.7%. Overall survival rates were 89.0, 60.4, and 60.4%, respectively.

Conclusions: This first comprehensive U.S. analysis of LT for CRLM suggests a burgeoning interest in high-volume U.S. transplant centers. Strategies to optimize patient selection are limited by the scarce oncologic history provided in UNOS data, warranting a separate registry to study LT in CRLM.

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Conflict of interest statement

The authors declare no conflicts or competing interests as described by Liver Transplantation.

Figures

Fig. 1
Fig. 1
a Annual case numbers of listed CRLM patients. b Annual case numbers of transplanted CRLM patients. c Many CRLM patients travel for LT for CRLM. d Post-LT outcomes
Fig. 2
Fig. 2
a Post LT survival outcomes according to donor types. b Post LT survival outcomes according to pre-LT MELD score. c Post LT survival comparison between CRLM and high risk HCC. d Post LT survival comparison between CRLM and intra/hilar cholangiocarcinoma. CRLM Colorectal liver metastases, LT Liver transplant, MELD Model for end-stage liver disease
See this image and copyright information in PMC

Comment in

References

    1. Sapisochin G, Hibi T, Toso C, et al. Transplant oncology in primary and metastatic liver tumors. Ann Surg. 2021;273(3):483–493. doi: 10.1097/sla.0000000000004071. - DOI - PubMed
    1. Mühlbacher F, Huk I, Steininger R, et al. Is orthotopic liver transplantation a feasible treatment for secondary cancer of the liver? Transplant Proc. 1991;23(1 Pt 2):1567–1568. - PubMed
    1. Hagness M, Foss A, Line PD, et al. Liver transplantation for nonresectable liver metastases from colorectal cancer. Ann Surg. 2013;257(5):800–806. doi: 10.1097/SLA.0b013e3182823957. - DOI - PubMed
    1. Dueland S, Syversveen T, Solheim JM, et al. Survival following liver transplantation for patients with nonresectable liver-only colorectal metastases. Ann Surg. 2020;271(2):212–218. doi: 10.1097/SLA.0000000000003404. - DOI - PubMed
    1. Line PD, Ruffolo LI, Toso C, Dueland S, Nadalin S, Hernandez-Alejandro R. Liver transplantation for colorectal liver metastases: What do we need to know? Int J Surg. 2020;82S:87–92. doi: 10.1016/j.ijsu.2020.03.079. - DOI - PubMed

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