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How tumors respond to treatment prior to liver transplants may be useful in selecting recipients

The results of this study appear in the August 2006 issue of Liver Transplantation, the official journal of the American Association for the Study of Liver Diseases (AASLD) and the International Liver Transplantation Society (ILTS). The journal is published on behalf of the societies by John Wiley & Sons, Inc. and is available online via Wiley InterScience at http://www.interscience.wiley.com/journal/livertransplantation.

Liver transplantation is widely recognized as an effective treatment for early-stage hepatocellular carcinoma (HCC) and the size and number of tumors, known as the Milan criteria, are traditionally used to determine a patient's eligibility for a transplant. Treating tumors prior to transplant has been used as a strategy to bridge the waiting time before an organ becomes available, but little research has been conducted on whether pre-treatment may influence survival.

Led by Gerd Otto, M.D. of the Department of Transplantation and Hepatobiliopancreatic Surgery at Johannes Gutenberg University in Mainz, Germany, researchers selected 96 HCC patients between May 1996 and May 1998 for periodic transarterial chemoembolization (TACE) prior to liver transplantation. TACE is a treatment where agents designed to halt or reduce tumor growth are injected into the artery supplying the tumor. The treatment was repeated every six weeks and every time a CT scan was performed to assess tumor growth.

Of the 96 patients, some initially met the Milan criteria, which screens for smaller tumors and fewer lesions, and were immediately listed for transplant, while others exceeded the Milan criteria initially but responded to TACE and were subsequently listed, even though some of them ultimately had tumors that exceeded the criteria before receiving a transplant. Ultimately, 16 patients met the Milan criteria and were transplanted and another 34 exceeded the Milan
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Contact: David Greenberg
dgreenbe@wiley.com
201-748-6484
John Wiley & Sons, Inc.
1-Aug-2006


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