1. Challenges in Liver Transplantation for Hepatocellular Carcinoma: A Review of Current Controversies.
- Author
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Mauro, Ezequiel, Sanduzzi-Zamparelli, Marco, Jutras, Gabrielle, Garcia, Raquel, Soler Perromat, Alexandre, Llarch, Neus, Holguin Arce, Victor, Ruiz, Pablo, Rimola, Jordi, Lopez, Eva, Ferrer-Fàbrega, Joana, García-Criado, Ángeles, Colmenero, Jordi, Lai, Jennifer C., and Forner, Alejandro
- Subjects
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PATIENT selection , *PUBLIC health surveillance , *NURSES , *OCCUPATIONAL roles , *CANCER relapse , *SURVIVAL rate , *FRAIL elderly , *IMMUNOTHERAPY , *CANCER patients , *TREATMENT effectiveness , *ALLIED health personnel , *NURSE practitioners , *MEDICAL radiology , *HEPATOCELLULAR carcinoma , *LIVER transplantation , *COMORBIDITY , *IMMUNOSUPPRESSION , *HEALTH care teams - Abstract
Simple Summary: Liver transplantation (LT) is one of the primary treatments for hepatocellular carcinoma (HCC) and significantly improves patient survival. However, the application of LT for HCC faces challenges owing to advancements in cancer-specific treatments and increased patient comorbidities. This review explores the current controversies and advancements in LT for HCC, focusing on managing comorbidities, the impact of frailty, selection criteria, the role of radiology, and the potential use of immunotherapy. We emphasize the importance of immunosuppression management and surveillance for HCC recurrence. A multidisciplinary approach is crucial to optimize the outcomes of patients with HCC undergoing LT, ensuring comprehensive care and improved survival rates. Liver transplantation (LT) remains one of the most effective treatments for hepatocellular carcinoma (HCC) and significantly enhances patient survival. However, the application of LT for HCC faces challenges owing to advancements in cancer-specific treatment modalities and the increased burden of patients' comorbidities. This narrative review explores current controversies and advancements in LT for HCC. Key areas of focus include the management of comorbidities and patient education by advanced practice nurses, impacts of frailty on waitlists and post-LT outcomes, selection criteria for LT in the era of new downstaging tools, role of radiology in patient selection, and implications of potential immunotherapy use both before and after LT. Additionally, the importance of immunosuppression management with strategies aimed at minimizing rejection while considering the risk of HCC recurrence and the role of surveillance for HCC recurrence is highlighted. This review also underscores the importance of a multidisciplinary approach for optimizing outcomes in patients with HCC undergoing LT. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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