TY - JOUR
T1 - Revisiting the indications for liver transplantation in cirrhotic patients considering the long-term outcomes of cirrhotic patients
AU - Ishigami, Masatoshi
AU - Honda, Takashi
AU - Kuzuya, Teiji
AU - Ishizu, Yoji
AU - Ito, Takanori
AU - Kamei, Hideya
AU - Ogura, Yasuhiro
AU - Fujishiro, Mitsuhiro
N1 - Publisher Copyright:
© 2020 Japanese Society of Hepato-Biliary-Pancreatic Surgery
PY - 2020/9/1
Y1 - 2020/9/1
N2 - Background: In this study, we investigated long-term survival of cirrhotic patients without hepatocellular carcinoma (HCC) and the proper timing of liver transplantation in the era with recent progress of management. Methods: We first classified 217 non-transplant cirrhotic patients without HCC according to the long-term survival based on Child-Turcotte-Pugh (CTP) scores and the MELD scores. We then compared them with the survival after liver transplantation in 114 patients with liver cirrhosis. Results: We classified into four groups (class A as CTP score of 5,6, B as 7,8, C as 9-12, D as 13-15) according to the long-term survival of the patients, the survivals of patients with class C and D were significantly worse compared with transplant patients (P < 0.001 in each group). And we also classified into four groups based on the MELD scores (class A as MELD score of −8, B as 9-12, C as 13-19, D as 19-), the survivals of patients with class C and D were significantly worse compared with those of transplant patients (P < 0.001 in each group). Conclusions: Considering the long-term survival of patients with liver cirrhosis, CTP score of 9 and/or MELD score of 13 could be a proper timing for liver transplantation.
AB - Background: In this study, we investigated long-term survival of cirrhotic patients without hepatocellular carcinoma (HCC) and the proper timing of liver transplantation in the era with recent progress of management. Methods: We first classified 217 non-transplant cirrhotic patients without HCC according to the long-term survival based on Child-Turcotte-Pugh (CTP) scores and the MELD scores. We then compared them with the survival after liver transplantation in 114 patients with liver cirrhosis. Results: We classified into four groups (class A as CTP score of 5,6, B as 7,8, C as 9-12, D as 13-15) according to the long-term survival of the patients, the survivals of patients with class C and D were significantly worse compared with transplant patients (P < 0.001 in each group). And we also classified into four groups based on the MELD scores (class A as MELD score of −8, B as 9-12, C as 13-19, D as 19-), the survivals of patients with class C and D were significantly worse compared with those of transplant patients (P < 0.001 in each group). Conclusions: Considering the long-term survival of patients with liver cirrhosis, CTP score of 9 and/or MELD score of 13 could be a proper timing for liver transplantation.
KW - Child-Turcotte-Pugh score
KW - MELD score
KW - liver cirrhosis
KW - long-term survival
KW - prognosis
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U2 - 10.1002/jhbp.777
DO - 10.1002/jhbp.777
M3 - Article
C2 - 32502307
AN - SCOPUS:85087568848
SN - 1868-6974
VL - 27
SP - 655
EP - 662
JO - Journal of Hepato-Biliary-Pancreatic Sciences
JF - Journal of Hepato-Biliary-Pancreatic Sciences
IS - 9
ER -