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The impact of transarterial chemoembolization induced complications on outcomes after liver transplantation: A propensity-matched study.
- Source :
-
Clinical transplantation [Clin Transplant] 2018 May; Vol. 32 (5), pp. e13255. Date of Electronic Publication: 2018 May 18. - Publication Year :
- 2018
-
Abstract
- Background: Loco-regional complications of transarterial chemoembolization (TACE) may adversely affect technical aspects of the liver transplantation (LT). This study reviewed the impact of those complications on postoperative outcomes encompassing implications on graft selection.<br />Methods: A retrospective, propensity score matching (1:1) analysis accounting for donor and recipient confounders was performed on a dataset of patients undergoing LT for hepatocellular carcinoma. Outcomes of patients who had TACE (TACE-group) were compared with those who did not (NoTACE-group).<br />Results: A total of 57 matched pairs were analyzed. TACE achieved effective tumor control (Pre-TACE vs Post-TACE; Median: 44 mm [interquartile range: 43-50] vs 17 mm [0-36]; P = .002) on imaging follow-up. TACE group had, at the hepatectomy, higher incidence of ischemia-related complications (adhesions of the necrotic tumor, cholecystitis, and/or bile duct necrosis) (40.4% vs 10.5%; P = .001). Overall major post-LT complications rate (Dindo-Clavien ≥3) were similar (P = .134). Those in the TACE group with donors after circulatory death (DCD) had 4.6% 90-day mortality and 54.3% major complication rate compared to 6.9% and 77.3% (P = .380 and P = .112, respectively).<br />Conclusion: TACE was an effective bridging procedure that may complicate LT inducing ischemic-related complications; nevertheless, it has not shown repercussions on mortality or morbidity after the procedure, even using donors after circulatory death.<br /> (© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
- Subjects :
- Carcinoma, Hepatocellular pathology
Carcinoma, Hepatocellular therapy
Female
Follow-Up Studies
Graft Survival
Hepatectomy mortality
Humans
Liver Neoplasms pathology
Liver Neoplasms therapy
Male
Middle Aged
Neoplasm Recurrence, Local pathology
Neoplasm Recurrence, Local therapy
Propensity Score
Retrospective Studies
Risk Factors
Survival Rate
Treatment Outcome
Carcinoma, Hepatocellular mortality
Chemoembolization, Therapeutic mortality
Graft Rejection mortality
Liver Neoplasms mortality
Liver Transplantation mortality
Neoplasm Recurrence, Local mortality
Postoperative Complications
Subjects
Details
- Language :
- English
- ISSN :
- 1399-0012
- Volume :
- 32
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Clinical transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 29637619
- Full Text :
- https://doi.org/10.1111/ctr.13255