肝移植治疗肝癌的受者选择杭州标准在亲属活体供肝移植中的应用价值

目的 探讨肝移植治疗肝癌的受者选择杭州标准在亲属活体供肝移植中的应用价值,及其对术后存活的影响.方法 回顾分析43例亲属活体供肝移植受者的临床资料.按照是否符合米兰标准、Up-To-Seven标准及杭州标准将受者分组,比较各组纳入受者的例数、术后总体存活率及无瘤存活率.结果 符合杭州标准的受者例数比米兰标准增加了61.5 %(8/13),比Up-to-Seven标准增加了23.5 %(4/17).符合米兰标准的受者(13例)术后1、3年总体存活率和无瘤存活率分别为100 %、80.0 %和84.6 %、84.6 %;符合Up-to-Seven标准的受者(17例)术后1、3年总体存活率和无瘤存活率分别为100 %、75.2 %和87.5 %、81.2 %;符合杭州标准的受者(21例)术后1、3年总体存活率和无瘤存活率分别为100 %、80.0 %和89.5 %、84.2 %.3组间总体存活率和无瘤存活率的比较,差异均无统计学意义(P＞0.05).结论 杭州标准能将更多的肝癌患者纳入肝移植,且不影响术后总体存活率和无瘤存活率,是筛选肝癌患者接受亲属活体肝移植的有效标准.

Abstract：

Objective To investigate the clinical value of Hangzhou Criteria in selection of patients with hepatocellular carcinoma(HCC)for living donor liver transplantation(LDLT)and their effects on recipient's post-transplant survival.Methods A retrospective analysis was conducted on 43 patients with HCC who underwent LDLT in our center.All of the recipients were classified into subgroups according to Milan Criteria,Up-to-Seven Criteria and Hangzhou Criteria,and post-transplant total survival rate and tumor-free survival rate were compared among the criteria.Results The number of patients within Hangzhou Criteria was 61.5 %(8/13)more than that within Milan Criteria and 23.5 %(4/17)more than that within Up-to-Seven Criteria.The 1-,and 3-years total survival rate and tumor-free survival rate of the recipients within Milan Criteria(n=13)were 100 %,80.0 % and 84.6 %,84.6 %,those of the recipients within Up-to-Seven Criteria(n=17)were 100 %,75.2 % and 87.5 %,81.2 %,and those of the recipients within Hangzhou Criteria(n=21)were 100 %,80.0 % and 89.5 %,84.2 %,respectively.There was no significant difference among the three criteria in total survival rate and tumor-free survival rate(P>0.05).Conclusion Hangzhou Criteria further enrolled more liver transplantation candidates without decline of total survival rate and tumor-free survival.It is a more effective selection of HCC recipients for LDLT.

Clinical value of Hangzhou Criteria in selection of patients with hepatocellular carcinoma for living donor liver transplantation

Objective To investigate the clinical value of Hangzhou Criteria in selection of patients with hepatocellular carcinoma(HCC)for living donor liver transplantation(LDLT)and their effects on recipient's post-transplant survival.Methods A retrospective analysis was conducted on 43 patients with HCC who underwent LDLT in our center.All of the recipients were classified into subgroups according to Milan Criteria,Up-to-Seven Criteria and Hangzhou Criteria,and post-transplant total survival rate and tumor-free survival rate were compared among the criteria.Results The number of patients within Hangzhou Criteria was 61.5 %(8/13)more than that within Milan Criteria and 23.5 %(4/17)more than that within Up-to-Seven Criteria.The 1-,and 3-years total survival rate and tumor-free survival rate of the recipients within Milan Criteria(n=13)were 100 %,80.0 % and 84.6 %,84.6 %,those of the recipients within Up-to-Seven Criteria(n=17)were 100 %,75.2 % and 87.5 %,81.2 %,and those of the recipients within Hangzhou Criteria(n=21)were 100 %,80.0 % and 89.5 %,84.2 %,respectively.There was no significant difference among the three criteria in total survival rate and tumor-free survival rate(P>0.05).Conclusion Hangzhou Criteria further enrolled more liver transplantation candidates without decline of total survival rate and tumor-free survival.It is a more effective selection of HCC recipients for LDLT.