Recipient and Donor Outcomes After Living-Donor Liver Transplant for Unresectable Colorectal Liver Metastases

作者：Roberto Hernandez‐Alejandro, Luis I. Ruffolo, Kazunari Sasaki, Koji Tomiyama, Mark S. Orloff, Karen Pineda‐Solís, Amit Nair, Jennie Errigo, M. Katherine Dokus, Mark S. Cattral, Ian D. McGilvray, Anand Ghanekar, Steven S. Gallinger, Nazia Selzner, Marco P. A. W. Claasen, R. L. Burkes, Koji Hashimoto, Masato Fujiki, Cristiano Quintini, Bassam N. Estfan, Choon Hyuck David Kwon, Krishna V Menon, Federico Aucejo, Gonzalo Sapisochín · 发表于：JAMA Surgery · 年份：2022 · DOI：10.1001/jamasurg.2022.0300 · 被引用次数：118 · 研究领域：Hepatocellular Carcinoma Treatment and Prognosis、Organ Transplantation Techniques and Outcomes、Viral-associated cancers and disorders

Importance: Colorectal cancer is a leading cause of cancer-related death, and nearly 70% of patients with this cancer have unresectable colorectal cancer liver metastases (CRLMs). Compared with chemotherapy, liver transplant has been reported to improve survival in patients with CRLMs, but in North America, liver allograft shortages make the use of deceased-donor allografts for this indication problematic. Objective: To examine survival outcomes of living-donor liver transplant (LDLT) for unresectable, liver-confined CRLMs. Design, Setting, and Participants: This prospective cohort study included patients at 3 North American liver transplant centers with established LDLT programs, 2 in the US and 1 in Canada. Patients with liver-confined, unresectable CRLMs who had demonstrated sustained disease control on oncologic therapy met the inclusion criteria for LDLT. Patients included in this study underwent an LDLT between July 2017 and October 2020 and were followed up until May 1, 2021. Exposures: Living-donor liver transplant. Main Outcomes and Measures: Perioperative morbidity and mortality of treated patients and donors, assessed by univariate statistics, and 1.5-year Kaplan-Meier estimates of recurrence-free and overall survival for transplant recipients. Results: Of 91 evaluated patients, 10 (11%) underwent LDLT (6 [60%] male; median age, 45 years [range, 35-58 years]). Among the 10 living donors, 7 (70%) were male, and the median age was 40.5 years (range, 27-50 years). Kap...