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Liver Transplantation for Alcoholic Liver Disease and Hepatocellular Carcinoma

Multivisceral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, Via Giustiniani 2, 35128 Padua, Italy
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Cancers 2018, 10(2), 46; https://doi.org/10.3390/cancers10020046
Received: 18 December 2017 / Revised: 1 February 2018 / Accepted: 7 February 2018 / Published: 9 February 2018
(This article belongs to the Special Issue Alcohol and Cancer)
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PDF [238 KB, uploaded 9 February 2018]

Abstract

Hepatocellular carcinoma is one of the main important causes of cancer-related death and its mortality is increasingly worldwide. In Europe, alcohol abuse accounts for approximately half of all liver cancer cases and it will become the leading cause of hepatocellular carcinoma in the next future with the sharp decline of chronic viral hepatitis. The pathophysiology of alcohol-induced carcinogenesis involves acetaldehyde catabolism, oxidative stress and chronic liver inflammation. Genetic background plays also a significant role and specific patterns of gene mutations in alcohol-related hepatocellular carcinoma have been characterized. Survival is higher in patients who undergo specific surveillance programmes than in patients who do not. However, patients with alcohol cirrhosis present a significantly greater risk of liver decompensation than those with cirrhosis due to other aetiologies. Furthermore, the adherence to screening program can be suboptimal. Liver transplant for patients with Milan-in hepatocellular carcinoma represents the best possible treatment in case of tumour recurrence/progression despite loco-regional or surgical treatments. Long-term result after liver transplantation for alcohol related liver disease is good. However, cardiovascular disease and de novo malignancies can significantly hamper patients’ survival and should be carefully considered by transplant team. In this review, we have focused on the evolution of alcohol-related hepatocellular carcinoma epidemiology and risk factors as well as on liver transplantation in alcoholic patients with and without hepatocellular carcinoma. View Full-Text
Keywords: cirrhosis; alcohol; hepatocellular carcinoma; carcinogenesis; surveillance; liver transplantation cirrhosis; alcohol; hepatocellular carcinoma; carcinogenesis; surveillance; liver transplantation
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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Burra, P.; Zanetto, A.; Germani, G. Liver Transplantation for Alcoholic Liver Disease and Hepatocellular Carcinoma. Cancers 2018, 10, 46.

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