中国肝癌肝移植临床实践指南(2018版)

中国医师协会器官移植医师分会; 中华医学会器官移植学分会

doi:10.3969/j.issn.1001-5256.2019.02.008

中国肝癌肝移植临床实践指南(2018版)

DOI: 10.3969/j.issn.1001-5256.2019.02.008

基金项目:

国家科技重大专项(2017ZX100203205)；教育部长江学者奖励计划项目(T2014146)；

详细信息

中图分类号: R735.7
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出版历程
- 出版日期: 2019-02-20

The Chinese clinical practice guideline on liver transplantation for hepatocellular carcinoma (2018)

Research funding:

摘要

摘要:
<正>1前言据统计中国每年超过30万人死于肝细胞肝癌(以下简称肝癌),占全球肝癌死亡人数的一半左右。而肝移植是被全世界认可的治疗终末期肝病最有效的手段之一。我国自20世纪90年代掀起第二次肝移植热潮以来,肝移植事业发展迅猛,呈专业化和规模化发展态势,在移植数量和质量方面已接近或达到西方
- 癌,肝细胞 /
- 肝移植 /
- 中国 /
- 诊疗准则
- carcinoma, hepatocellular /
- liver transplantation /
- China /
- practice guideline

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参考文献(83)

[1]SCHUNEMANN HJ, OXMAN AD, BROZEK J, et al.Grading quality of evidence and strength of recommendations for diagnostic tests and strategies[J].BMJ, 2008, 336 (7653) :1106-1110.

[2]Oxford Centre for Evidence-based Medicine-Levels of Evidence (March 2009) [DB/OL].Oxford Centre for Evidencebased Medicine, 2009[2018-11-01].http://www.cebm.net/oxford-centre-evidence-based-medicine-levelsevidence-march-2009/.

[3]MAZZAFERRO V, REGALIA E, DOCI R, et al.Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis[J].N Engl J Med, 1996, 334 (11) :693-699.

[4]MAZZAFERRO V, BHOORI S, SPOSITO C, et al.Milan criteria in liver transplantation for hepatocellular carcinoma:An evidence-based analysis of 15 years of experience[J].Liver Transpl, 2011, 17 (Suppl 2) :s44-s57.

[5]European Liver Transplant Registry Results[DB/OL].European Liver Transplant Registry, 2011[2018-11-01].http://www.eltr.org.

[6]OPTN/SRTR Annual Report[DB/OL].Organ Procurement and Transplantation Network, 2011[2018-11-01].http://www.ustransplant.org.

[7]YAO FY, FERRELL L, BASS NM, et al.Liver transplantation for hepatocellular carcinoma:Expansion of the tumor size limits does not adversely impact survival[J].Hepatology, 2001, 33 (6) :1394-1403.

[8]MAZZAFERRO V, LLOVET JM, MICELI R, et al.Predicting survival after liver transplantation in patients with hepatocellular carcinoma beyond the Milan criteria:A retrospective, exploratory analysis[J].Lancet Oncol, 2009, 10 (1) :35-43.

[9]ZHENG SS, XU X, WU J, et al.Liver transplantation for hepatocellular carcinoma:Hangzhou experiences[J].Transplantation, 2008, 85 (12) :1726-1732.

[10]AUDET M, PANARO F, PIARDI T, et al.Are the Hangzhou criteria adaptable to hepatocellular carcinoma patients for liver transplantation in Western countries?[J].Liver Transpl, 2009, 15 (7) :822-823.

[11]CHEN J, XU X, WU J, et al.The stratifying value of Hangzhou criteria in liver transplantation for hepatocellular carcinoma[J].PLo S One, 2014, 9 (3) :e93128.

[12] XU X, YANG JY, ZHONG L, et al.The clinical value of"Hangzhou Criteria"in the selection of patients with hepatocellular carcinoma for liver transplantation:A report of 1163 cases on a multi-center basis[J].Chin J Organ Transplant, 2013, 34 (9) :524-527. (in Chinese) 徐骁, 杨家印, 钟林, 等.肝癌肝移植“杭州标准”多中心应用研究---1163例报道[J].中华器官移植杂志, 2013, 34 (9) :524-527.

[13]LEI JY, WANG WT, YAN LN.Hangzhou criteria for liver transplantation in hepatocellular carcinoma:A single-center experience[J].Eur J Gastroenterol Hepatol, 2014, 26 (2) :200-204.

[14]XIAO GQ, YANG JY, YAN LN.Combined Hangzhou criteria with neutrophil-lymphocyte ratio is superior to other criteria in selecting liver transplantation candidates with HBV-related hepatocellular carcinoma[J].Hepatobiliary Pancreat Dis Int, 2015, 14 (6) :588-595.

[15]FU H, ZHENG J, CAI J, et al.Systemic immune-inflammation index (SII) is useful to predict survival outcomes in patients after liver transplantation for hepatocellular carcinoma within Hangzhou criteria[J].Cell Physiol Biochem, 2018, 47 (1) :293-301.

[16]XU X, LU D, LING Q, et al.Liver transplantation for hepatocellular carcinoma beyond the Milan criteria[J].Gut, 2016, 65 (6) :1035-1041.

[17]ZHANG X, LI C, WEN T, et al.Outcomes of salvage liver transplantation and re-resection/radiofrequency ablation for intrahepatic recurrent hepatocellular carcinoma:A new surgical strategy based on recurrence pattern[J].Dig Dis Sci, 2018, 63 (2) :502-514.

[18]HU Z, WANG W, LI Z, et al.Recipient outcomes of salvage liver transplantation versus primary liver transplantation:A systematic review and meta-analysis[J].Liver Transpl, 2012, 18 (11) :1316-1323.

[19]CLAVIEN PA, LESURTEL M, BOSSUYT PM, et al.Recommendations for liver transplantation for hepatocellular carcinoma:An international consensus conference report[J].Lancet Oncol, 2012, 13 (1) :e11-e22.

[20]CHAPMAN WC, GARCIA-AROZ S, VACHHARAJANI N, et al.Liver transplantation for advanced hepatocellular carcinoma after downstaging without up-front stage restrictions[J].JAm Coll Surg, 2017, 224 (4) :610-621.

[21]GALUPPO R, MCCALL A, GEDALY R.The role of bridging therapy in hepatocellular carcinoma[J].Int J Hepatol, 2013:419302.

[22]European Association for the Study of the Liver, European Organisation for Research and Treatment of Cancer.EASL-EORTC clinical practice guidelines:Management of hepatocellular carcinoma[J].J Hepatol, 2012, 56 (4) :908-943.

[23]SALEM R, GORDON AC, MOULI S, et al.Y90 radioembolization significantly prolongs time to progression compared with chemoembolization in patients with hepatocellular carcinoma[J].Gastroenterology, 2016, 151 (6) :1155-1163.

[24]KLOMPENHOUWER EG, DRESEN RC, VERSLYPE C, et al.Safety and efficacy of transarterial radioembolisation in patients with intermediate or advanced stage hepatocellular carcinoma refractory to chemoembolisation[J].Cardiovasc Intervent Radiol, 2017, 40 (12) :1882-1890.

[25]GRAZIADEI I, ZOLLER H, FICKERT P, et al.Indications for liver transplantation in adults:Recommendations of the Austrian Society for Gastroenterology and Hepatology (OGGH) in cooperation with the Austrian Society for Transplantation, Transfusion and Genetics (ATX) [J].Wien Klin Wochenschr, 2016, 128 (19-20) :679-690.

[26]SAMOYLOVA ML, DODGE JL, YAO FY, et al.Time to transplantation as a predictor of hepatocellular carcinoma recurrence after liver transplantation[J].Liver Transpl, 2014, 20 (8) :937-944.

[27]LAI Q, AVOLIO AW, GRAZIADEI I, et al.Alpha-fetoprotein and modified response evaluation criteria in solid tumors progression after locoregional therapy as predictors of hepatocellular cancer recurrence and death after transplantation[J].Liver Transpl, 2013, 19 (10) :1108-1118.

[28]DUVOUX C, ROUDOT-THORAVAL F, DECAENS T, et al.Liver transplantation for hepatocellular carcinoma:A model including alpha-fetoprotein improves the performance of Milan criteria[J].Gastroenterology, 2012, 143 (4) :986-994.

[29]ASHOORI N, BAMBERG F, PAPROTTKA P, et al.Multimodality treatment for early-stage hepatocellular carcinoma:Abridging therapy for liver transplantation[J].Digestion, 2012, 86 (4) :338-348.

[30]MERANI S, MAJNO P, KNETEMAN NM, et al.The impact of waiting list alpha-fetoprotein changes on the outcome of liver transplant for hepatocellular carcinoma[J].J Hepatol, 2011, 55 (4) :814-819.

[31]MAILEY B, ARTINYAN A, KHALILI J, et al.Evaluation of absolute serum alpha-fetoprotein levels in liver transplant for hepatocellular cancer[J].Arch Surg, 2011, 146 (1) :26-33.

[32]MEHTA N, YAO FY.Living donor liver transplantation for hepatocellular carcinoma:To expand (beyond Milan) or downstage (to Milan) ?[J].Liver Transpl, 2018, 24 (3) :327-329.

[33]LLOVET JM, PAVEL M, RIMOLA J, et al.Pilot study of living donor liver transplantation for patients with hepatocellular carcinoma exceeding Milan criteria (Barcelona clinic liver cancer extended criteria) [J].Liver Transpl, 2018, 24 (3) :369-379.

[34]European Association for the Study of the Liver.EASL clinical practice guidelines:Liver transplantation[J].J Hepatol, 2016, 64 (2) :433-485.

[35]SASTRE J, DIAZ-BEVERIDGE R, GARCIA-FONCILLAS J, et al.Clinical guideline SEOM:Hepatocellular carcinoma[J].Clin Transl Oncol, 2015, 17 (12) :988-995.

[36]QU LS, LIU JX, ZHU J, et al.Risk factors for prognosis of hepatocellular carcinoma after curative resection in patients with low hepatitis B viral load[J].Ann Hepatol, 2017, 16 (3) :412-420.

[37]WONG JS, WONG GL, TSOI KK, et al.Meta-analysis:The efficacy of anti-viral therapy in prevention of recurrence after curative treatment of chronic hepatitis B-related hepatocellular carcinoma[J].Aliment Pharmacol Ther, 2011, 33 (10) :1104-1112.

[38]KODA M, NAGAHARA T, MATONO T, et al.Nucleotide analogs for patients with HBV-related hepatocellular carcinoma increase the survival rate through improved liver function[J].Intern Med, 2009, 48 (1) :11-17.

[39] European Association for the Study of the Liver, European Association for the Study of the Liver.EASL 2017 clinical practice guidelines on the management of hepatitis B virus infection[J].J Hepatol, 2017, 67 (2) :370-398.

[40]HU TH, CHEN CL, LIN CC, et al.Section 14.Combination of entecavir plus low-dose on-demand hepatitis B immunoglobulin is effective with very low hepatitis B recurrence after liver transplantation[J].Transplantation, 2014, 97 (Suppl 8) :s53-s59.

[41] YIN J, LI N, HAN Y, et al.Effect of antiviral treatment with nucleotide/nucleoside analogs on postoperative prognosis of hepatitis B virus-related hepatocellular carcinoma:A twostage longitudinal clinical study[J].J Clin Oncol, 2013, 31 (29) :3647-3655.

[42]LAI CL, YUEN MF.Prevention of hepatitis B virus-related hepatocellular carcinoma with antiviral therapy[J].Hepatology, 2013, 57 (1) :399-408.

[43]HUANG G, LAI EC, LAU WY, et al.Posthepatectomy HBV reactivation in hepatitis B-related hepatocellular carcinoma influences postoperative survival in patients with preoperative low HBV-DNA levels[J].Ann Surg, 2013, 257 (3) :490-505.

[44]CHEN CJ, YANG HI, ILOEJE UH, et al.Hepatitis B virus DNAlevels and outcomes in chronic hepatitis B[J].Hepatology, 2009, 49 (5 Suppl) :s72-s84.

[45]FUNG J, WONG T, CHOK K, et al.Long-term outcomes of entecavir monotherapy for chronic hepatitis B after liver transplantation:Results up to 8 years[J].Hepatology, 2017, 66 (4) :1036-1044.

[46]KIM JM, JOH JW, KIM SJ, et al.Steroid withdrawal in adult liver transplantation:Occurrence at a single center[J].Transplant Proc, 2010, 42 (10) :4132-4136.

[47]LO CM, LAU GK, CHAN SC, et al.Efficacy of a pre-S containing vaccine in patients receiving lamivudine prophylaxis after liver transplantation for chronic hepatitis B[J].Am J Transplant, 2007, 7 (2) :434-439.

[48]LO CM, LIU CL, CHAN SC, et al.Failure of hepatitis B vaccination in patients receiving lamivudine prophylaxis after liver transplantation for chronic hepatitis B[J].J Hepatol, 2005, 43 (2) :283-287.

[49]SANCHEZ-FUEYO A, RIMOLA A, GRANDE L, et al.Hepatitis B immunoglobulin discontinuation followed by hepatitis B virus vaccination:A new strategy in the prophylaxis of hepatitis B virus recurrence after liver transplantation[J].Hepatology, 2000, 31 (2) :496-501.

[50]YOUNOSSI ZM, STEPANOVA M, SULKOWSKI M, et al.Patient-reported outcomes in patients co-infected with hepatitis C virus and human immunodeficiency virus treated with sofosbuvir and velpatasvir:The ASTRAL-5 study[J].Liver Int, 2017, 37 (12) :1796-804.

[51]YOUNOSSI ZM, STEPANOVA M, SULKOWSKI M, et al.Ribavirin-free regimen with sofosbuvir and velpatasvir is associated with high efficacy and improvement of patient-reported outcomes in patients with genotypes 2 and 3 chronic hepatitis C:Results from astral-2 and-3 clinical trials[J].Clin Infect Dis, 2016, 63 (8) :1042-1048.

[52]YOUNOSSI ZM, STEPANOVA M, FELD J, et al.Sofosbuvir/velpatasvir improves patient-reported outcomes in HCV patients:Results from ASTRAL-1 placebo-controlled trial[J].J Hepatol, 2016, 65 (1) :33-39.

[53]YOUNOSSI ZM, STEPANOVA M, CHARLTON M, et al.Patient-reported outcomes with sofosbuvir and velpatasvir with or without ribavirin for hepatitis C virus-related decompensated cirrhosis:An exploratory analysis from the randomised, open-label ASTRAL-4 phase 3 trial[J].Lancet Gastroenterol Hepatol, 2016, 1 (2) :122-132.

[54]LEVITSKY J, VERNA EC, O'LEARY JG, et al.Perioperative ledipasvir-sofosbuvir for HCV in liver-transplant recipients[J].N Engl J Med, 2016, 375 (21) :2106-2108.

[55]TERRAULT NA, MCCAUGHAN GW, CURRY MP, et al.International liver transplantation society consensus statement on hepatitis C management in liver transplant candidates[J].Transplantation, 2017, 101 (5) :945-955.

[56]CURRY MP, FORNS X, CHUNG RT, et al.Sofosbuvir and ribavirin prevent recurrence of HCV infection after liver transplantation:An open-label study[J].Gastroenterology, 2015, 148 (1) :100-107.

[57]UEDA Y, IKEGAMI T, AKAMATSU N, et al.Treatment with sofosbuvir and ledipasvir without ribavirin for 12 weeks is highly effective for recurrent hepatitis C virus genotype 1b infection after living donor liver transplantation:A Japanese multicenter experience[J].J Gastroenterol, 2017, 52 (8) :986-991.

[58]BELLI LS, DUVOUX C, BERENGUER M, et al.ELITA consensus statements on the use of DAAs in liver transplant candidates and recipients[J].J Hepatol, 2017, 67 (3) :585-602.

[59]MANNS M, SAMUEL D, GANE EJ, et al.Ledipasvir and sofosbuvir plus ribavirin in patients with genotype 1 or 4 hepatitis C virus infection and advanced liver disease:A multicentre, open-label, randomised, phase 2 trial[J].Lancet Infect Dis, 2016, 16 (6) :685-697.

[60]KWO PY, MANTRY PS, COAKLEY E, et al.An interferonfree antiviral regimen for HCV after liver transplantation[J].NEngl J Med, 2014, 371 (25) :2375-2382.

[61]CHEN K, MAN K, METSELAAR HJ, et al.Rationale of personalized immunosuppressive medication for hepatocellular carcinoma patients after liver transplantation[J].Liver Transpl, 2014, 20 (3) :261-269.

[62]WEI Q, GAO F, ZHUANG R, et al.A national report from China Liver Transplant Registry:Steroid avoidance after liver transplantation for hepatocellular carcinoma[J].Chin J Cancer Res, 2017, 29 (5) :426-437.

[63]YANIK EL, CHINNAKOTLA S, GUSTAFSON SK, et al.Effects of maintenance immunosuppression with sirolimus after liver transplant for hepatocellular carcinoma[J].Liver Transpl, 2016, 22 (5) :627-634.

[64]GEISSLER EK, SCHNITZBAUER AA, ZULKE C, et al.Sirolimus use in liver transplant recipients with hepatocellular carcinoma:A randomized, multicenter, open-label phase 3 trial[J].Transplantation, 2016, 100 (1) :116-125.

[65]MENON KV, HAKEEM AR, HEATON ND.Meta-analysis:Recurrence and survival following the use of sirolimus in liver transplantation for hepatocellular carcinoma[J].Aliment Pharmacol Ther, 2013, 37 (4) :411-419.

[66]FORONCEWICZ B, MUCHA K, RYSZKOWSKA E, et al.Safety and efficacy of steroid-free immunosuppression with tacrolimus and daclizumab in liver transplant recipients:6-year follow-up in a single center[J].Transplant Proc, 2009, 41 (8) :3103-3106.

[67]VIVARELLI M, CUCCHETTI A, LA BARBA G, et al.Liver transplantation for hepatocellular carcinoma under calcineurin inhibitors:Reassessment of risk factors for tumor recurrence[J].Ann Surg, 2008, 248 (5) :857-862.

[68]NAIR S, EASON J, LOSS G.Sirolimus monotherapy in nephrotoxicity due to calcineurin inhibitors in liver transplant recipients[J].Liver Transpl, 2003, 9 (2) :126-129.

[69]CHOLONGITAS E, MAMOU C, RODRGUEZ-CASTRO KI, et al.Mammalian target of rapamycin inhibitors are associated with lower rates of hepatocellular carcinoma recurrence after liver transplantation:A systematic review[J].Transpl Int, 2014, 27 (10) :1039-1049.

[70]XU SL, ZHANG YC, WANG GY, et al.Survival analysis of sirolimus-based immunosuppression in liver transplantation in patients with hepatocellular carcinoma[J].Clin Res Hepatol Gastroenterol, 2016, 40 (6) :674-681.

[71]TARANTINO G, MAGISTRI P, BALLARIN R, et al.Oncological impact of M-Tor inhibitor immunosuppressive therapy after liver transplantation for hepatocellular carcinoma:Review of the literature[J].Front Pharmacol, 2016, 7:387.

[72]SAPISOCHIN G, BRUIX J.Liver transplantation for hepatocellular carcinoma:Outcomes and novel surgical approaches[J].Nat Rev Gastroenterol Hepatol, 2017, 14 (4) :203-217.

[73]BODZIN AS, LUNSFORD KE, MARKOVIC D, et al.Predicting mortality in patients developing recurrent hepatocellular carcinoma after liver transplantation:Impact of treatment modality and recurrence characteristics[J].Ann Surg, 2017, 266 (1) :118-125.

[74]SAPISOCHIN G, GOLDARACENA N, ASTETE S, et al.Benefit of treating hepatocellular carcinoma recurrence after liver transplantation and analysis of prognostic factors for survival in a large Euro-American series[J].Ann Surg Oncol, 2015, 22 (7) :2286-2294.

[75]SHETTY K, DASH C, LAURIN J.Use of adjuvant sorafenib in liver transplant recipients with high-risk hepatocellular carcinoma[J].J Transplant, 2014, 2014:913634.

[76]HUANG L, LI GM, ZHU JY, et al.Efficacy of sorafenib after liver transplantation in patients with primary hepatic carcinoma exceeding the Milan criteria:A preliminary study[J].Onco Targets Ther, 2012, 5:457-462.

[77]ZHANG Q, CHEN H, LI Q, et al.Combination adjuvant chemotherapy with oxaliplatin, 5-fluorouracil and leucovorin after liver transplantation for hepatocellular carcinoma:A preliminary open-label study[J].Invest New Drugs, 2011, 29 (6) :1360-1369.

[78]SAAB S, MCTIGUE M, FINN RS, et al.Sorafenib as adjuvant therapy for high-risk hepatocellular carcinoma in liver transplant recipients:Feasibility and efficacy[J].Exp Clin Transplant, 2010, 8 (4) :307-313.

[79]XU J, SHEN ZY, CHEN XG, et al.A randomized controlled trial of Licartin for preventing hepatoma recurrence after liver transplantation[J].Hepatology, 2007, 45 (2) :269-276.

[80]SATAPATHY SK, DAS K, KOCAK M, et al.No apparent benefit of preemptive sorafenib therapy in liver transplant recipients with advanced hepatocellular carcinoma on explant[J].Clin Transplant, 2018, 32 (5) :e13246.

[81]de'ANGELIS N, LANDI F, NENCIONI M, et al.Role of sorafenib in patients with recurrent hepatocellular carcinoma after liver transplantation[J].Prog Transplant, 2016, 26 (4) :348-355.

[82]MANCUSO A, MAZZOLA A, CABIBBO G, et al.Survival of patients treated with sorafenib for hepatocellular carcinoma recurrence after liver transplantation:A systematic review and meta-analysis[J].Dig Liver Dis, 2015, 47 (4) :324-330.

[83]ZHOU B, SHAN H, ZHU KS, et al.Chemoembolization with lobaplatin mixed with iodized oil for unresectable recurrent hepatocellular carcinoma after orthotopic liver transplantation[J].J Vasc Interv Radiol, 2010, 21 (3) :333-338.

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