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Outcomes After Liver Transplantation With Incidental Cholangiocarcinoma

Safdar, NZ; Hakeem, AR; Faulkes, R; James, F; Mason, L; Masson, S; Powell, J; ... Parker, R; + view all (2022) Outcomes After Liver Transplantation With Incidental Cholangiocarcinoma. Transplant International , 35 , Article 10802. 10.3389/ti.2022.10802. Green open access

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Abstract

Cholangiocarcinoma (CCA) is currently a contraindication to liver transplantation (LT) in the United Kingdom (UK). Incidental CCA occurs rarely in some patients undergoing LT. We report on retrospective outcomes of patients with incidental CCA from six UK LT centres. Cases were identified from pathology records. Data regarding tumour characteristics and post-transplant survival were collected. CCA was classified by TNM staging and anatomical location. 95 patients who underwent LT between 1988–2020 were identified. Median follow-up after LT was 2.1 years (14 days-18.6 years). Most patients were male (68.4%), median age at LT was 53 (IQR 46-62), and the majority had underlying PSC (61%). Overall median survival after LT was 4.4 years. Survival differed by tumour site: 1-, 3-, and 5-year estimated survival was 82.1%, 68.7%, and 57.1%, respectively, in intrahepatic CCA (n = 40) and 58.5%, 42.6%, and 30.2% in perihilar CCA (n = 42; p = 0.06). 1-, 3-, and 5-year estimated survival was 95.8%, 86.5%, and 80.6%, respectively, in pT1 tumours (28.2% of cohort), and 65.8%, 44.7%, and 31.1%, respectively, in pT2-4 (p = 0.018). Survival after LT for recipients with incidental CCA is inferior compared to usual outcomes for LT in the United Kingdom. LT for earlier stage CCA has similar survival to LT for hepatocellular cancer, and intrahepatic CCAs have better survival compared to perihilar CCAs. These observations may support LT for CCA in selected cases.

Type: Article
Title: Outcomes After Liver Transplantation With Incidental Cholangiocarcinoma
Location: Switzerland
Open access status: An open access version is available from UCL Discovery
DOI: 10.3389/ti.2022.10802
Publisher version: https://doi.org/10.3389/ti.2022.10802
Language: English
Additional information: Copyright © 2022 Safdar, Hakeem, Faulkes, James, Mason, Masson, Powell, Rowe, Shetty, Jones, Spiers, Halliday, Baker, Thorburn, Prasad and Parker. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
Keywords: distal, hepatocellular, hilar, indication, intrahepatic, survival, transplant, tumor, Humans, Male, Female, Liver Transplantation, Bile Duct Neoplasms, Retrospective Studies, Cholangiocarcinoma, Bile Ducts, Intrahepatic
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inst for Liver and Digestive Hlth
URI: https://discovery.ucl.ac.uk/id/eprint/10163752
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