Impact of Living Donor Liver Transplantation on the Improvement of Hepatocellular Carcinoma Treatment

Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related deaths, with increasing incidence. There are different treatment options, but only 30%-40% of HCC cases are diagnosed at an early stage for curative treatment. With the implementation of Milan Criteria for liver transplantation (LT) in HCC cases and its use for organ allocation with successful outcomes, LT has become an optimal treatment. Seeking new criteria for LT and developing updated algorithms for HCC treatment has become a hot topic nowadays. With the experience in living donor liver transplantation (LDLT), especially in Asian countries, LDLT was established and adopted with different criteria for HCC treatment, especially including criteria beyond Milan's size and number of tumors. Living donor grafts are uniquely different than deceased donor grafts as they are not considered a public resource. A living donor graft is rather a private gift intended for a specific recipient. Living donor livers are not limited by organ allocation systems, and this significant advantage of LDLT has opened new frontiers in the treatment of HCC. Improvements in LDLT have had remark-able parallel effects in the successful treatment of HCC as supported by a growing body of literature in the past decade.

Hepatosellüler Karsinom Tedavisindeki Ýlerlemeye Canlý Vericiden Karaciðer Naklinin Etkisi

Hepatosellüler Karsinom (HSK), artan insidansý ile kanser iliþkili ölümlerde önde gelen nedenlerden biridir. Birçok tedavi seçeneði olmakla birlikte ancak olgularýn sadece %30-40'ýna küratif tedavi þansý olabilen erken evrede taný konulabilmektedir. Baþarýlý sonuçlarile HSK'lu hastalarda karaciðer naklinde ve organ daðýtýmýnda milan kriterlerinin (MK) uygulanmasý ile karaciðer nakli en uygun tedavi konumuna gelmiþtir. HKS tedavisinde yeni kriter arayýþlarý ve tedavi algoritmalarýndaki güncellemeler sýcak konulardýr. Asya ülkelerinde artan canlý vericiden karaciðer nakli (CVKN) deneyimi ile özellikle tümör sayýsý ve boyutundan baðýmsýz olarak MK dýþýndaki HSK'da CVKN uygulanmýþ ve benimsenmiþtir. CVKN greftleri özellikleri ile kadavra donörlerden toplumsal kaynak olmamasý ile farklýdýr. Canlý donor karaciðer grefti bir kiþiye baðýþlanmýþ özel bir hediyedir. Canlý donör karaciðer nakli organ daðýtýmýndan baðýmsýz olmasý sayesinde HSK tedavisinde yeni ufuklar açmýþtýr. Son dekatlarda,CVKNde olan ilerleme ile paralel olarak HSK tedavisinde çok baþarýlý ilerlemelere artan oranda literatürde rastlanmaktadýr. (SETB-2023-03-044)