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Brain, cardiac death allografts did not increase HCC recurrence

Donations after brain and cardiac death allografts did not increase a patient’s likelihood of developing hepatocellular carcinoma recurrence after liver transplantation, according to newly published data in the American Journal of Transplantation.

Researchers, including Kristopher P. Croome, MD, MS, department of transplantation, Mayo Clinic, Jacksonville, analyzed data from 1,876 patients who underwent donation after brain death (DBD) and donation after cardiac death (DCD) at the Mayo Clinic between 2003 and 2012. Liver transplantation for hepatocellular carcinoma (HCC) was found in 397 recipients (DBD 340, DCD 57) and were included in the final analysis to determine any patterns and rates of HCC recurrence.

Kristopher P. Croome

“I believe this study firmly and finally answers the question as to whether liver donations after cardiac death are as viable for patients with liver cancer as livers from donors who die from brain death,” Croome said in a press release. “They are — we now know that these organs effectively offer new life for patients with liver cancer.”

Results indicated that HCC recurrence rates were comparable between the patients in the DBD group and DCD group (12.1% vs. 12.3%). More patients in the DBD group experienced recurrence compared with the DCD group (41 vs. 7).

No differences were observed in tumor number (P = .26) tumor volume (P = .34) and alpha-fetoprotein (P = .47) levels between the DCD group and the DBD group. In addition, no difference between recurrence-free survival and cumulative incidence of HCC recurrence was found between the two groups (P = .29, P = .91), respectively.  

Using organs after cardiac death for liver transplants could increase the number of transplants performed by 10% to 15% nationwide, according to Croome.

“One reason why the wait time for liver transplant is short at Mayo Clinic in Florida is that we efficiently and successfully use both types of donated livers,” Croome said in the release. “But nationwide, over the last decade, the transplant list and the number of liver cancer patients are increasing.

The gap between patients who need a new liver and the number of organs available has been widening, but the use of donations after cardiac death could potentially alleviate some of the organ shortage.” – by Melinda Stevens

Disclosure: The researchers report no relevant financial disclosures.