Challenges in Liver Transplantation for Hepatocellular Carcinoma: A Review of Current Controversies.
Ezequiel MauroMarco Sanduzzi-ZamparelliGabrielle JutrasRaquel GarciaAlexandre Soler PerromatNeus LlarchVictor Holguin ArcePablo RuizJordi RimolaEva LopezJoana Ferrer-FàbregaÁngeles García-CriadoJordi ColmeneroJennifer C LaiAlejandro FornerPublished in: Cancers (2024)
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.
Keyphrases
- case report
- healthcare
- end stage renal disease
- free survival
- ejection fraction
- quality improvement
- mental health
- newly diagnosed
- chronic kidney disease
- artificial intelligence
- squamous cell carcinoma
- risk assessment
- adipose tissue
- young adults
- patient reported outcomes
- peritoneal dialysis
- human health
- squamous cell
- combination therapy
- deep learning
- weight loss
- replacement therapy