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001-es BibID:	BIBFORM064144
Első szerző:	Nemes Balázs Áron (sebész)
Cím:	The Impact of Milan Criteria on Liver Transplantation for Hepatocellular Carcinoma : first 15 Years' Experience of the Hungarian Liver Transplant Program / B. Nemes, F. Gelley, L. Piros, G. Zádori, D. Görög, I. Fehérvári, L. Kóbori, E. Sárváry, P. Nagy, A. Kiss, A. Doros
Dátum:	2011
ISSN:	0041-1345
Megjegyzések:	In addition to hepatitis C, hepatocellular carcinoma.1 is a leading indication for orthotopicliver transplantation (OLT). The indications for OLT in HCC remains a topic of debate.The successful Milan criteria are still accepted as the gold standard to select candidateswith a good chance for long-term survival.2 The Hungarian Liver Transplant Programlaunched in 1995 reached 45 OLT/year in 2010.3,4 Among 412 first OLTs, there were 49cases of a malignant tumor, including 41 among which the indication was the tumor. Of the412 patients, 154 (37.4%) were hepatitic C virus (HCV) positive, including 29 with HCCand 23 cases in which HCC was the indication itself. Half of the HCC patients were withinthe Milan criteria;15 50% exceeded the criteria.14 We observed a solitary HCC in 36% ofcases: 2 foci in 18%; 3 in 7%, 4 in 14%, and 5 in 25%. Only 12 patients underwent a"down-staging" treatment before OLT: 8 radiofrequency ablation (RFA) and 4 transarterialchemoembolization (TACE). Cumulative 1-, 3-, and 5-year patient survivals were62%, 54%, and 43%, respectively in HCC/HCV?positive patients and they were 74%,67%, and 61% among non-HCC HCV-positive subjects. The cumulative HCC patientsurvival rates of 64%, 64%, and 53% among Milan criteria were superior to those of 57%,40%, and 27% among subjects exceeding the Milan criteria (P .01). Pre-OLT"down-staging" treatment increased the 1-year patient survival from 64% to 70%;however, it did not affect the long-term results. Among items of the Milan criteria tumorsize had less impact on outcomes then number of foci. The majority of cases who exceededthe Milan criteria had been transplanted before 2003. Our results suggested that the Milancriteria should be applied for the selection of candidates in order to promise good survivalafter OLT for HCC.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:	Transplantation Proceedings. - 43 : 4 (2011), p. 1272-1274. -
További szerzők:	Gelley Fanni Piros László Zádori Gergely (1983-) (sebész) Görög Dénes Fehérvári Imre Kóbori László Sárváry Enikő Nagy Péter Kiss András Doros Attila
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