Tumors with intrahepatic bile duct differentiation in cirrhosis: Implications on outcomes after liver transplantation

Marcelo E. Facciuto; Manoj K. Singh; Nir Lubezky; Motaz A. Selim; Dorothy Robinson; Leona Kim-Schluger; Sander Florman; Stephen C. Ward; Swan N. Thung; Mariaisabel Fiel; Thomas D. Schiano

doi:10.1097/TP.0000000000000286

Tumors with intrahepatic bile duct differentiation in cirrhosis: Implications on outcomes after liver transplantation

Marcelo E. Facciuto, Manoj K. Singh, Nir Lubezky, Motaz A. Selim, Dorothy Robinson, Leona Kim-Schluger, Sander Florman, Stephen C. Ward, Swan N. Thung, Mariaisabel Fiel, Thomas D. Schiano

Research output: Contribution to journal › Article › peer-review

64 Scopus citations

Abstract

Background. The role of liver transplantation (LT) in the management of cirrhotic patients with tumors exhibiting intrahepatic bile duct differentiation remains controversial. The objective of this study was to characterize the spectrum of these tumors and analyze post-LT outcomes.

Methods. Retrospective pathology database search of explant histology analysis of liver transplants between April 1993 and November 2013.

Results. Thirty-two patients were analyzed, 75% were men with a mean age of 60 years. Seven patients had nodules demonstrating intrahepatic cholangiocarcinoma (I-CCA), nine had I-CCA nodules occurring concomitantly with hepatocellular carcinoma (HCC), and 16 had mixed HCC-CCA nodules. The median number of tumors was 1 and size was 2.5 cm. Overall patient survival post-LT at 1 and 5 years was 71% and 57%, respectively. Patients within Milan criteria, especially with I-CCA features, showed a 5-year tumor recurrence rate (10%) and 5-year survival rate (78%) comparable with other patients having HCC within Milan criteria.

Conclusion. This series showed that patients with CCA within Milan criteria may be able to achieve acceptable long-term post-LT survival.

Original language	English
Pages (from-to)	151-157
Number of pages	7
Journal	Transplantation
Volume	99
Issue number	1
DOIs	https://doi.org/10.1097/TP.0000000000000286
State	Published - 15 Jan 2015

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title = "Tumors with intrahepatic bile duct differentiation in cirrhosis: Implications on outcomes after liver transplantation",

abstract = "Background. The role of liver transplantation (LT) in the management of cirrhotic patients with tumors exhibiting intrahepatic bile duct differentiation remains controversial. The objective of this study was to characterize the spectrum of these tumors and analyze post-LT outcomes.Methods. Retrospective pathology database search of explant histology analysis of liver transplants between April 1993 and November 2013.Results. Thirty-two patients were analyzed, 75% were men with a mean age of 60 years. Seven patients had nodules demonstrating intrahepatic cholangiocarcinoma (I-CCA), nine had I-CCA nodules occurring concomitantly with hepatocellular carcinoma (HCC), and 16 had mixed HCC-CCA nodules. The median number of tumors was 1 and size was 2.5 cm. Overall patient survival post-LT at 1 and 5 years was 71% and 57%, respectively. Patients within Milan criteria, especially with I-CCA features, showed a 5-year tumor recurrence rate (10%) and 5-year survival rate (78%) comparable with other patients having HCC within Milan criteria.Conclusion. This series showed that patients with CCA within Milan criteria may be able to achieve acceptable long-term post-LT survival.",

author = "Facciuto, {Marcelo E.} and Singh, {Manoj K.} and Nir Lubezky and Selim, {Motaz A.} and Dorothy Robinson and Leona Kim-Schluger and Sander Florman and Ward, {Stephen C.} and Thung, {Swan N.} and Mariaisabel Fiel and Schiano, {Thomas D.}",

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doi = "10.1097/TP.0000000000000286",

language = "English",

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pages = "151--157",

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TY - JOUR

T1 - Tumors with intrahepatic bile duct differentiation in cirrhosis

T2 - Implications on outcomes after liver transplantation

AU - Facciuto, Marcelo E.

AU - Singh, Manoj K.

AU - Lubezky, Nir

AU - Selim, Motaz A.

AU - Robinson, Dorothy

AU - Kim-Schluger, Leona

AU - Florman, Sander

AU - Ward, Stephen C.

AU - Thung, Swan N.

AU - Fiel, Mariaisabel

AU - Schiano, Thomas D.

PY - 2015/1/15

Y1 - 2015/1/15

N2 - Background. The role of liver transplantation (LT) in the management of cirrhotic patients with tumors exhibiting intrahepatic bile duct differentiation remains controversial. The objective of this study was to characterize the spectrum of these tumors and analyze post-LT outcomes.Methods. Retrospective pathology database search of explant histology analysis of liver transplants between April 1993 and November 2013.Results. Thirty-two patients were analyzed, 75% were men with a mean age of 60 years. Seven patients had nodules demonstrating intrahepatic cholangiocarcinoma (I-CCA), nine had I-CCA nodules occurring concomitantly with hepatocellular carcinoma (HCC), and 16 had mixed HCC-CCA nodules. The median number of tumors was 1 and size was 2.5 cm. Overall patient survival post-LT at 1 and 5 years was 71% and 57%, respectively. Patients within Milan criteria, especially with I-CCA features, showed a 5-year tumor recurrence rate (10%) and 5-year survival rate (78%) comparable with other patients having HCC within Milan criteria.Conclusion. This series showed that patients with CCA within Milan criteria may be able to achieve acceptable long-term post-LT survival.

AB - Background. The role of liver transplantation (LT) in the management of cirrhotic patients with tumors exhibiting intrahepatic bile duct differentiation remains controversial. The objective of this study was to characterize the spectrum of these tumors and analyze post-LT outcomes.Methods. Retrospective pathology database search of explant histology analysis of liver transplants between April 1993 and November 2013.Results. Thirty-two patients were analyzed, 75% were men with a mean age of 60 years. Seven patients had nodules demonstrating intrahepatic cholangiocarcinoma (I-CCA), nine had I-CCA nodules occurring concomitantly with hepatocellular carcinoma (HCC), and 16 had mixed HCC-CCA nodules. The median number of tumors was 1 and size was 2.5 cm. Overall patient survival post-LT at 1 and 5 years was 71% and 57%, respectively. Patients within Milan criteria, especially with I-CCA features, showed a 5-year tumor recurrence rate (10%) and 5-year survival rate (78%) comparable with other patients having HCC within Milan criteria.Conclusion. This series showed that patients with CCA within Milan criteria may be able to achieve acceptable long-term post-LT survival.

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SN - 0041-1337

VL - 99

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JO - Transplantation

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Tumors with intrahepatic bile duct differentiation in cirrhosis: Implications on outcomes after liver transplantation

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