Survival rates are similar among patients with hepatitis B who are listed for liver transplantation, whether or not they have hepatocellular carcinoma (HCC), according to a new study in the March 2007 issue of Liver Transplantation. An accompanying editorial suggests that these results affirm the current policy on the allocation of donor livers.
The study and the editorial appear in the March 2007 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.
The United Network for Organ Sharing (UNOS) utilizes the Model for End-Stage Liver Disease (MELD) to determine allocation of available organs. Patients with hepatocellular carcinoma have higher MELD scores, and may be more likely to receive transplants quickly compared to patients with other types of liver disease. Without transplant, many HCC patients die or become unsuitable for transplantation because of tumor progression.
Led by Anna S. Lok, M.D. of the Division of Gastroenterology at the University of Michigan, researchers set out to compare clinical outcomes for hepatitis B patients awaiting a liver transplant, whether or not they had HCC. They enrolled 279 patients from the National Institutes of Health-sponsored HBV-OLT study between November 2001 and June 2005. Of these patients 183 had HBV with cirrhosis, and 96 had HBV with HCC. Most were receiving antiviral therapy. The researchers collected demographic and laboratory data for all participants, and computed a MELD score for each. They then followed the patients for a median of 30.2 months.