The role of liver transplant for intrahepatic cholangiocarcinoma:the UK NHSBT liver advisory group pilot programme  

作　　者：Abdul Rahman Hakeem John Isaac Douglas Thorburn Nigel Heaton Raj Prasad on behalf of the NHS Blood and Transplant Liver Transplantation for Cholangiocarcinoma Fixed Term Working Group 

机构地区：[1]Consultant Liver Transplant and Hepatobiliary Surgeon,Department of Hepatobiliary Surgery and Liver Transplantation,St James’s Hospital NHS Trust,Leeds LS97TF,UK [2]Consultant Liver Transplant and Hepatobiliary Surgeon,Liver Unit,Queen Elizabeth Hospital,University Hospitals Birmingham NHS Foundation Trust,Birmingham B152WB,UK [3]Consultant Hepatologist,Sheila Sherlock Liver Center,The Royal Free London NHS Foundation Trust,London NW32QG,UK [4]Consultant Liver Transplant and Hepatopancreatobiliary Surgeon,Institute of Liver Studies,King's College Hospital,London SE59RS,UK [5]Department of Hepatopancreatobiliary Surgery and Liver Transplantation,Froedtert Hospital,Milwaukee,WI 53226,USA [6]不详

出　　处：《Hepatoma Research》2023年第1期616-629,共14页肝癌研究(英文版)

摘　　要：Aim:Liver transplantation(LT)offers a potential curative treatment for non-metastatic intrahepatic cholangiocarcinoma(iCCA)in patients with chronic liver disease who are not amenable to liver resection(LR).Recent evidence suggests that cirrhotic patients with“very early”iCCA(single tumour,≤2 cm)might benefit the most from LT,with a 5-year survival as high as 73%.In view of these developments,NHS Blood and Transplant’s Liver Advisory Group(LAG)established a Fixed Term Working Group(FTWG)to determine whether iCCA in patients with background cirrhosis should be considered for LT in the United Kingdom.Methods:The FTWG included cholangiocarcinoma/LT patient representatives,experts in cholangiocarcinoma surgery/oncology,LT surgery,hepatology,hepatobiliary radiology,hepatobiliary pathology,nuclear medicine,and representation from various national hepatobiliary/oncology and transplant professional bodies.The objective was to make recommendations on appropriate indications,patient selection criteria,referral criteria,radiological assessment,transplant listing pathways,data management,and overall quality assurance.Results:The FTWG recommended LT for very early iCCA in cirrhotics,who are otherwise not suitable for LR.In this paper,we summarise the selection criteria,patient pathways,referral framework,pre-transplant assessment criteria,outcome measures,and dissemination strategy for implementing this new indication for LT in the UK.Conclusion:The introduction and evaluation of this pilot programme is an important breakthrough for iCCA patients in the UK,marking a significant stride in the field of transplant oncology.The results of this service evaluation will describe the role of LT in iCCA and guide future programmes to optimise patient selection,management,and outcomes.

关 键 词：Intrahepatic cholangiocarcinoma liver transplantation working group pilot programme OUTCOMES 

分 类 号：R73[医药卫生—肿瘤]