An Early Regional Experience with Expansion of Milan Criteria for Liver Transplant Recipients

作者：Guiteau J J; Cotton R T; Washburn W K; Harper A; O'Mahony C A; Sebastian A; Cheng S; Klintmalm G; Ghobrial M; Halff G; Mieles L; Goss J^*

来源：American Journal of Transplantation, 2010, 10(9): 2092-2098.

DOI：10.1111/j.1600-6143.2010.03222.x

• Milan Criteria
• liver transplantation
• expanding Milan Criteria
• hepatocellular carcinoma

The adult OLT programs in UNOS Region 4 reached an agreement allowing lesions outside MC (one lesion < 6 cm, < 3 lesions, none > 5 cm and total diameter < 9 cm-[R4 T3]) to receive the same exception points as MC lesions. Kaplan-Meier curves and log-rank tests were used to compare survival data. Chi-squared and Mann-Whitney U tests were used to compare patient data. A p-value of < 0.05 was considered significant. All statistical analyses were performed on SPSS 15 (SPSS, Chicago, IL).
Four hundred and forty-five patients were transplanted for HCC (363-MC and 82-R4 T3). Patient demographics were found to be similar between the two groups. Three year patient, allograft and recurrence free survival between MC and R4 T3 were found to be 72.9% and 77.1%, 71% and 70.2% and 90.5% and 86.9%, respectively (all p > 0.05).
We report the first regionalized multicenter, prospective study showing benefit of OLT in patients exceeding MC based on preoperative imaging.

• 出版日期2010-9