Abstract：
The aim of this work was to assess the association between graft-to-recipient weight ratio (GRWR) in adult-to-adult living donor liver transplantation (LDLT) and hepatocellular carcinoma (HCC) recurrence. A search of the MEDLINE and EMBASE databases was performed until December 2022 for studies comparing different GRWRs in the prognosis of HCC recipients in LDLT. Data were pooled to evaluate 1- and 3-year survival rates. We identified three studies, including a total of 782 patients (168 GRWR < 0.8 vs. 614 GRWR ≥ 0.8%). The pooled overall survival was 85% and 77% at one year and 90% and 83% at three years for GRWR < 0.8 and GRWR ≥ 0.8, respectively. The largest series found that, in patients within Milan criteria, the GRWR was not associated with lower oncological outcomes. However, patients with HCC outside the Milan criteria with a GRWR < 0.8% had lower survival and higher tumor recurrence rates. The GRWR < 0.8% appears to be associated with lower survival rates in HCC recipients, particularly for candidates with tumors outside established HCC criteria. Although the data are scarce, the results of this study suggest that considering the individual GRWR not only as risk factor for small-for-size-syndrome but also as contributor to HCC recurrence in patients undergoing LDLT would be beneficial. Novel perfusion technologies and pharmacological interventions may contribute to improving outcomes.
摘要：
这项工作的目的是评估成人至成人活体肝移植（LDLT）中移植物与受体体重比（GRWR）与肝细胞癌（HCC）复发之间的关联。直到2022年12月，对MEDLINE和EMBASE数据库进行了搜索，以比较LDLT中HCC受者预后的不同GRWR。收集数据以评估1年和3年生存率。我们确定了三项研究，包括总共782例患者(168例GRWR<0.8vs.614GRWR≥0.8%)。GRWR<0.8和GRWR≥0.8的患者1年总生存率分别为85%和77%，3年总生存率分别为90%和83%。最大的系列发现，在符合米兰标准的患者中，GRWR与较低的肿瘤结局无关.然而,不符合米兰标准且GRWR<0.8%的HCC患者的生存率较低,肿瘤复发率较高.GRWR<0.8％似乎与肝癌患者的生存率较低有关。特别是对于患有既定HCC标准之外的肿瘤的候选人。虽然数据很少,这项研究的结果表明,在接受LDLT的患者中,考虑个体GRWR不仅是小尺寸综合征的危险因素,而且是HCC复发的原因将是有益的.新的灌注技术和药物干预可能有助于改善结果。
