Carcinoma hepatocelular pós transplante hepático: análise de 10 anos

• Ano de defesa: 2012
• Autor(a) principal: Silva, Joyce Roma Lucas de
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Programa de Pós-graduação em Ciências Médicas; Ciências Médicas
• Palavras-chave em Português: Carcinoma Hepatocelular; Transplante Hepático; Recidiva; MELD; Sobrevida; MEDICINA; CIÊNCIAS MÉDICAS; Taxa de sobrevida; Transplante de fígado; Hepatocellular Carcinoma; Liver Transplantation; Survival; Recurrence; Meld sore; CNPQ::CIENCIAS DA SAUDE::MEDICINA::CLINICA MEDICA
• Link de acesso: https://app.uff.br/riuff/handle/1/19652

Currently, the best treatment with curative potential for hepatocellular carcinoma (HCC) is liver transplantation (LT). Post LT survival is related to both early tumor diagnosis and more efficient therapeutic techniques. However, we found different HCC recurrence rates in patients within the same criteria for LT suggesting that other factors may be responsible for tumor recurrence after LT. The main of this study was to analyze the recurrence in HCC patients who underwent LT in a center where the donor pool is limited, and assess the impact of the current organ allocation system in this center. A retrospective study of HCC patients data who underwent) deceased donor and living donor liver transplantation according to inclusion and exclusion criteria was performed between June 2001 and June 2011. The follow up ranged from 10 months to 10 years after LT. We analyzed deceased donor and living donor survival, before and after the MELD score implementation in the latter group. Of the 423 liver transplants, 93 (21.98%) patients were select with confirmed HCC in the explant. In the overall analysis, we observed 14 recurrences (15%). Of these, 4 (28.5%) performed locoregional therapy. Half recurrences (7 cases) occurred in the liver and the other half occurred in the lung (5 cases), bone (1 case) and lymphonodes (1 case). The mean time between LT and diagnosis of recurrence was of 7.57 ± 4.71 months with a median of 6 months, ranging from 2 to 17 months. Risk factors affecting survival in this population were the presence of vascular invasion with the risk of 12.27 times (95% CI 2.92 51.51, p = 0.006). Vascular invasion in association to donor type had an impact on survival at 3 years (p = 0.35). The survival rates were similar in both groups living donor and deceased donor, with no significant differences (p=0.39). Additionally, the MELD score did not change the long-term survival of patients who underwent deceased donor liver transplantation at our center