Validation of Japanese indication criteria for deceased donor liver transplantation for hepatocellular carcinoma: Analysis of US national registry data

Aim The Japanese indication criteria for liver transplantation (LT) for hepatocellular carcinoma (HCC) have been updated based on living donor LT data to include either the Milan criteria (MC) or the 5‐5‐500 rule, which requires a nodule size of ≤5 cm, ≤5 nodules, and an alpha‐fetoprotein (AFP) leve...

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Bibliographic Details
Published in:Hepatology research 2024-07, Vol.54 (7), p.695-705
Main Authors: Bekki, Yuki, Itoh, Shinji, Toshima, Takeo, Shimokawa, Mototsugu, Yoshizumi, Tomoharu
Format: Article
Language:English
Subjects:
5‐5‐500 rule
HCC
Hepatocellular carcinoma
Liver cancer
Liver transplantation
Liver transplants
Milan criteria
Nodules
Survival
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Summary:Aim The Japanese indication criteria for liver transplantation (LT) for hepatocellular carcinoma (HCC) have been updated based on living donor LT data to include either the Milan criteria (MC) or the 5‐5‐500 rule, which requires a nodule size of ≤5 cm, ≤5 nodules, and an alpha‐fetoprotein (AFP) level ≤500 ng/mL. We aimed to validate the 5‐5‐500 rule and the MC for deceased donor LT (DDLT). Methods Using national registry data from the United States from 2010 to 2014, we separated DDLT patients into four groups based on the MC and the 5‐5‐500 rule. The AFP values were stratified into categories: ≤100, 101–300, 301–500, and >500 ng/mL. Results The 5‐year survival rate was significantly lower for patients in the groups within MC/beyond 5‐5‐500 (56.3%) or beyond MC/5‐5‐500 (60.7%) than for patients in the groups within MC/5‐5‐500 (76.2%) and beyond MC/within 5‐5‐500 (72.3%) (p 500 categories, respectively (p 
ISSN:1386-6346
1872-034X
DOI:10.1111/hepr.14017