Ann Liver Transplant.  2024 Nov;4(2):102-107. 10.52604/alt.24.0017.

Outcomes of living donor liver transplantation in patients with concurrent extrahepatic malignancy

• Park JH
• Kim J
• An S
• Oh N
• Rhu J
• Choi GS
• Joh JW

• KMID: 2561855
• DOI: http://doi.org/10.52604/alt.24.0017

Abstract

Background
Concurrently extrahepatic malignancy (EHM) has long been considered a relative contraindication to liver transplantation because of cancer recurrence. However, we were frequently challenged as living donor liver transplantation (LDLT) may be the only life-saving option available in the setting of end-stage liver disease, or hepatocellular carcinoma (HCC) with concurrent EHM. In this study, we aim to analyze the outcome of adult LDLT with concurrent EHM at the time of LDLT.
Methods
Of 2,448 adults who underwent LDLT from May 1996 to January 2023 at our institution, we retrospectively analyzed data for 16 patients with an EHM treated within 6 months at the time of LDLT.
Results
Among 16 patients, one patient died of postoperative liver failure, and another died 3 months post-surgery due to bowel perforation. The cumulative overall survival rates at 1-year, 3-year, and 5-year were 87.5%, 78.8%, and 68.9%, respectively. Five patients died during follow-up; only one patient died due to a cancer-related cause. None of the eight patients with low-risk EHM showed EHM recurrence after LDLT. EHM recurrence occurred in one patient with intermediate risk, and cancer progression was seen in one patient with high-risk EHM. Concurrent HCC was present in six patients, and HCC recurrence occurred in two (33.33%). There was no statistically significant difference in survival between patients with hematologic (n=5) and non-hematologic (n=11) EHM (p=0.891).
Conclusion
Our study shows a high survival rate for LDLT in patients with concurrently EHM. Hence, we suggest that concurrent EHM should not be a contraindication to LDLT even when ‘minimum remission times’ have not yet elapsed.

Keyword

Living donors; Survival; Recurrence