The Revolution in Indication for Liver Transplantation: Will Liver Metastatic Disease Overcome the End-Stage Liver Disease in the Next Future?
Abstract
:1. Introduction
2. Material and Methods: Literature Research
2.1. Search Strategy
2.2. Inclusion and Exclusion Criteria
3. Liver Transplantation for Metastatic Liver Tumours
3.1. Neuroendocrine Tumours—Natural History and Approach to Liver Transplantation
3.2. Liver Transplantation: Outcomes
3.3. Colorectal Liver Metastasis—Natural History and Approach to Liver Transplantation
3.4. Liver Transplantation: Outcomes
4. Strategies for Organs Allocation and Ethical Considerations
5. Immunosuppression Administration
6. Conclusions
Author Contributions
Funding
Conflicts of Interest
Abbreviations
ALF | Acute Liver Failure |
CNI | Calcineurin Inhibitors |
CRLM | Colorectal Liver Metastasis |
ELTR | European Liver Transplant Registry |
ESLD | End-Stage Liver Disease |
HCC | Hepatocellular carcinoma |
LT | Liver Transplantation |
MELD | Model for End-stage Liver Disease |
NET | Neuroendocrine tumors |
PNET | Pancreatic neuroendocrine tumors |
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First Author (Year of Publication) | Study Design | Primary Tumor | N. of LT Patients | Tumor Location (%) | Patients with Metastases (N) | CHT preTx (N) | 5-Year OS (%) | 5 Year DFS (%) |
---|---|---|---|---|---|---|---|---|
Le Treut (2008) [19] | Multicenter experience | NET | 85 | Bronchial tree (5); Stomach (3); Jejunum (6); Ileum (16); Rectum (4); Duodenum, pancreas (41); Undetected (10) | 12 | 70 | 47 | 20 |
Nguyen (2011) [20] | Registry databases | NET | 184 | N/A | N/A | N/A | 49.2 | NR |
Gedaly (2011) [21] | Registry databases | NET | 150 | Metastatic carcinoid (51);Insulinoma (6); Glucagonoma (3); Gastrinoma (11); VIP tumour (9): Undetected (70) | 51 | N/A | 48 | 32 |
Le Treut (2013) [10] | Registry databases | NET | 213 | Bronchial tree (16); Stomach (8); Jejunum (16); Ileum (48); Colon (5) Rectum (6); Duodenum, pancreas (97); Common bile duct (1); Undetected (17) | 56 | 161 | 52 | 30 |
Sher (2015) [9] | Multicenter experience | NET | 85 | Duodenum, pancreas (42); Digestive tract (24) Undetected (19) | N/A | N/A | 52 | NR |
Nobel (2015) [22] | Registry databases | NET | 120 | Carcinoid (34); ACTH-producing (1); Insulinoma (5); Glucagonoma (7); Gastrinoma (2); VIP tumour (4); Islet cell (9); Undetected (58) | N/A | N/A | 63 | NR |
Pasqual (2016) [23] | Multicenter experience | NET | 4 | Stomach (4); Ileum (6); Colon (3); Duodenum (2); Esophagus (1); Pancreas (8); Lung (1); Undetected (1) | 22 | N/A | 50 | NR |
Single multicenter experiences (1989–2020) [24,25,26] | Single centre experience | NET | 11 | Rectum (2); Small bowel (3); Pancreas (3); Stomach (1); Undetected (2) | 1 | 1 | 70.9 | 26.8 |
First Author (Year of Publication) | Study Design | No. of LT Patients | Tumor Location | Patients with Metastases | Max Size at LT in cm (pt) | Chemothreapy preTx | 5-Year OS (%) | 5 Year DFS (%) |
---|---|---|---|---|---|---|---|---|
Hagness (2013) [30] | Prospective study | 21 | Colon 11 (52) Rectum 10 (48) | <6 (4) 6–9 (9) ≥10 (8) | <5 (12) 5–10 (5) >10 (4) | 21 | 60 | NR |
Compagnons Hépato-Bilaires group (2017) [33] | Retrospective multicenter study | 12 | Colon 11 (91) Rectum 1 (9) | <6 (6) 6–9 (1) ≥10 (5) | <5 (4) 5–10 (1) >10 (7) | 11 | 50 | 38 |
Dueland (2020) [34] | Prospective study | 15 | Colon 3 (20) Sigmoid 8 (53) Rectum 4 (27) | <6 (9) 6–9 (2) ≥10 (4) | <5 (15) 5–10 (0) >10 (0) | 15 | 83 | NR |
Study Name | Year | Country | Indication | Estimated Patient Enrollment | Allocation | Type of Donor | Clinical Trial Number |
---|---|---|---|---|---|---|---|
COLT | 2019 | Italy | CRLM | 22 | Non-randomized | Cadaveric | NCT03803436 |
LiverT(w)oHeal | 2018 | Germany | CRLM | 40 | NA | Living | NCT03488953 |
Toronto Living Donor study | 2016 | Canada | CRLM | 20 | NA | Living | NCT02864485 |
SECA-III | 2016 | Norway | CRLM | 30 | Randomized | Cadaveric | NCT03494946 |
TRANSMET | 2015 | France | CRLM | 90 | Randomized | Cadaveric | NCT02597348 |
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Manzia, T.M.; Parente, A.; Angelico, R.; Gazia, C.; Tisone, G. The Revolution in Indication for Liver Transplantation: Will Liver Metastatic Disease Overcome the End-Stage Liver Disease in the Next Future? Transplantology 2020, 1, 111-122. https://doi.org/10.3390/transplantology1020011
Manzia TM, Parente A, Angelico R, Gazia C, Tisone G. The Revolution in Indication for Liver Transplantation: Will Liver Metastatic Disease Overcome the End-Stage Liver Disease in the Next Future? Transplantology. 2020; 1(2):111-122. https://doi.org/10.3390/transplantology1020011
Chicago/Turabian StyleManzia, Tommaso Maria, Alessandro Parente, Roberta Angelico, Carlo Gazia, and Giuseppe Tisone. 2020. "The Revolution in Indication for Liver Transplantation: Will Liver Metastatic Disease Overcome the End-Stage Liver Disease in the Next Future?" Transplantology 1, no. 2: 111-122. https://doi.org/10.3390/transplantology1020011