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      Progression-Free Survival for Liver Transplant vs Alternative Therapy in Unresectable Colorectal Liver Metastasis

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          Abstract

          This cohort study compares survival outcomes between patients with unresectable colorectal liver metastasis who received chemotherapy-based multimodal therapy and patients who underwent liver transplant.

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          Recipient and Donor Outcomes After Living-Donor Liver Transplant for Unresectable Colorectal Liver Metastases

          Roberto Hernandez-Alejandro, Luis I. Ruffolo, Kazunari Sasaki … (2022)
          This cohort study examines overall and recurrence-free survival outcomes in adult patients with liver-confined, unresectable colorectal cancer liver metastases who underwent a living-donor liver transplant.
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            Survival Benefit of Living-Donor Liver Transplant

            Whitney E. Jackson, John Malamon, Bruce Kaplan … (2022)
            Key Points Question Compared with the wait list, what is the survival benefit of a living-donor liver transplant for patients with end-stage liver disease based on patients’ Model for End-stage Liver Disease incorporating sodium levels (MELD-Na) score? Findings In this case-control study of 119 275 liver transplant candidates, patients with a MELD-Na score as low as 11 had a 34% decrease in mortality compared with those who remained on the wait list. Patients who received a living-donor liver transplant can expect to gain an additional 13 to 17 years of life compared with those who never received a transplant. Meaning This study’s findings challenge current perceptions regarding when the survival benefit of a living-donor transplant occurs.
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              The Current State of Liver Transplantation for Colorectal Liver Metastases in the United States: A Call for Standardized Reporting

              Kazunari Sasaki, Luis I. Ruffolo, Michelle H. Kim … (2023)
              Background Current success in transplant oncology for select liver tumors, such as hepatocellular carcinoma, has ignited international interest in liver transplantation (LT) as a therapeutic option for nonresectable colorectal liver metastases (CRLM). In the United States, the CRLM LT experience is limited to reports from a handful of centers. This study was designed to summarize donor, recipient, and transplant center characteristics and posttransplant outcomes for the indication of CRLM. Methods Adult, primary LT patients listed between December 2017 and March 2022 were identified by using United Network Organ Sharing database. LT for CRLM was identified from variables: “DIAG_OSTXT”; “DGN_OSTXT_TCR”; “DGN2_OSTXT_TCR”; and “MALIG_TY_OSTXT.” Results During this study period, 64 patients were listed, and 46 received LT for CRLM in 15 centers. Of 46 patients who underwent LT for CRLM, 26 patients (56.5%) received LTs using living donor LT (LDLT), and 20 patients received LT using deceased donor (DDLT) (43.5%). The median laboratory MELD-Na score at the time of listing was statistically similar between the LDLT and DDLT groups (8 vs. 9, P = 0.14). This persisted at the time of LT (8 vs. 12, P = 0.06). The 1-, 2-, and 3-year, disease-free, survival rates were 75.1, 53.7, and 53.7%. Overall survival rates were 89.0, 60.4, and 60.4%, respectively. Conclusions This first comprehensive U.S. analysis of LT for CRLM suggests a burgeoning interest in high-volume U.S. transplant centers. Strategies to optimize patient selection are limited by the scarce oncologic history provided in UNOS data, warranting a separate registry to study LT in CRLM.
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                Author and article information

                Journal
                Title: JAMA Surgery
                Abbreviated Title: JAMA Surg
                Publisher: American Medical Association (AMA)
                ISSN (Print): 2168-6254
                Publication date (Electronic): July 24 2024
                Affiliations
                [1 ]Department of Surgery, University of Rochester Medical Center, Rochester, New York
                [2 ]Department of Surgery, Division of Transplantation and Hepatobiliary Surgery, University of Rochester Medical Center, Rochester, New York
                [3 ]Department of Breast Surgical Oncology, MD Anderson Cancer Center, Houston, Texas
                Article
                DOI: 10.1001/jamasurg.2024.2057
                SO-VID: a6cb8fc4-ce92-4453-a682-ba99f988d1f5
                Copyright © © 2024
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