Living-donor or deceased-donor liver transplantation for hepatic carcinoma: A case-matched comparison

Table 1 Clinical characteristics n (%)

Variable	LDLT (n = 40)	DDLT ( n= 80)	P value
Age (yr)	48.6 ± 9.7	49.5 ± 8.9	0.614
Gender			> 0.999
Male	34 (85.0)	68 (85.0)
Female	6 (15.0)	12 (15.0)
MELD score			0.354
6-9	7 (17.5)	22 (27.5)
10-19	28 (70.0)	49 (61.2)
20-29	3 (7.5)	8 (10.0)
30-40	2 (5.0)	1 (1.3)
Child-Pugh score			0.898
A	12 (30.0)	25 (31.2)
B	18 (45.0)	38 (47.5)
C	10 (25.0)	17 (21.3)
Previous hepatic resection	3 (7.5)	6 (7.5)	> 0.999
Preoperative down-staging treatment	12 (30.0)	29 (36.3)	0.496
Liver cirrhosis			> 0.999
Hepatitis B cirrhosis	39 (97.5)	77 (96.3)
Alcoholic cirrhosis	0	1 (1.3)
Autoimmune cirrhosis	0	1 (1.3)
No cirrhosis	1 (2.5)	1 (1.3)
Comorbidities
Hypertension	4 (10.0)	8 (10.0)	> 0.999
Diabetes mellitus	4 (10.0)	8 (10.0)	> 0.999
Cardiac disease	0	1 (1.3)	> 0.999
Cerebrovascular disease	1 (2.5)	4 (5.0)	0.872
Previous abdominal surgery	11 (27.5)	13 (16.3)	0.146

LDLT: Living-donor liver transplantation; DDLT: Deceased-donor liver transplantation; MELD: Model for end-stage liver disease.

Table 2 Preoperative serological detection outcomes n (%)

Variable	LDLT (n = 40)	DDLT (n = 80)	P value
Serum alpha-fetoprotein			0.331
< 400 ng/mL	25 (62.5)	57 (71.2)
≥ 400 ng/mL	15 (37.5)	23 (28.8)
Blood group			0.132
A	10 (25.0)	25 (31.3)
B	11 (27.5)	28 (35.0)
AB	2 (5.0)	9 (11.3)
O	17 (42.5)	18 (22.5)
HBVsAg positive	40 (100.0)	76 (95.0)	0.369
HBV DNA			0.297
< 1000 copies/mL	20 (50.0)	32 (40.0)
≥ 1000 copies/mL	20 (50.0)	48 (60.0)
HCV antibody positive	0	0	> 0.999

LDLT: Living-donor liver transplantation; DDLT: Deceased-donor liver transplantation; HBVsAg: Hepatitis B virus surface antigen; HCV: Hepatitis C virus.

Table 3 Perioperative outcomes and oncological characteristics n (%)

Variable	LDLT ( n= 40)	DDLT (n = 80)	P value
Duration of operation (min)	553 ± 105	445 ± 75	< 0.001
Estimated blood loss (mL)	1188 ± 824	1035 ± 1072	0.055
Intraoperative transfusion	24 (60.0)	35 (43.8)	0.093
Tumor pathological type			0.557
HCC	39 (97.5)	79 (98.8)
ICC	0	1 (1.3)
cHCC-CC	1 (2.5)	0
Tumor size (cm)	3.8 ± 1.9	4.1 ± 2.3	0.708
Tumor number			0.238
Single	27 (67.5)	62 (77.5)
Multiple	13 (32.5)	18 (22.5)
Vascular invasion	3 (7.5)	4 (5.0)	0.890
Within Milan criteria	24 (60.0)	48 (60.0)	> 0.999
Outside Milan criteria (Pittsburgh staging)			> 0.999
I	12 (30.0)	24 (30.0)
IVa	2 (5.0)	4 (5.0)
IVb	2 (5.0)	4 (5.0)

Data are expressed as absolute mean ± SD or numbers (percentage). LDLT: Living-donor liver transplantation; DDLT: Deceased-donor liver transplantation; HCC: Hepatocellular carcinoma; ICC: Intrahepatic cholangiocarcinoma; cHCC-CC: Combined hepatocellular carcinoma and cholangiocarcinoma.

Table 4 Perioperative complications (modified Clavien-Dindo classification) n (%)

Grade	LDLT ( n= 40)	DDLT (n = 80)	P value
Grade I	3 (7.5)	5 (6.3)	> 0.999
Wound infection	3	4
Mental symptom	0	1
Grade II	18 (45.0)	52 (65.0)	0.036
Postoperative bacterial infection	11	35
Virus infection	2	2
Bile leak	2	0
Hypertension	1	2
Mental symptom	1	4
Acute rejection	0	5
Peripheral nerve injury	0	1
Intra-abdominal bleeding	1	2
Subdural hematoma	0	1
Grade IIIa	3 (7.5)	0	0.063
Biliary stricture	1	0
Hepatic artery thrombosis	1	0
Wound dehiscence	1	0
Grade IIIb	2 (5.0)	10 (12.5)	0.333
Intra-abdominal bleeding	0	5
Bile leak	2	1
Wound dehiscence	0	2
Biliary stricture	0	1
Hepatic artery thrombosis	0	1
Grade IVa	0	2 (2.5)	0.552
Renal insufficiency	0	2
Grade IVb	1 (2.5)	1 (1.3)	> 0.999
MODS	1	1
Grade V	1 (2.5)	4 (5.0)	0.872
Death	1	4
Overall	21 (52.5)	46 (57.5)	0.603

LDLT: Living-donor liver transplantation; DDLT: Deceased-donor liver transplantation; MODS: Multiple organ dysfunction syndrome.

Table 5 Overall biliary complications n (%)

Biliary complications	LDLT (n = 40)	DDLT (n = 80)	P value
Perioperative period	5 (12.5)	2 (2.5)	0.073
Bile leak	4	1
Biliary stricture	1	1
Long-term follow-up period	6 (15.0)	4 (5.0)	0.129
Biliary stricture	6	4
Overall	11 (27.5)	6 (7.5)	0.003

LDLT: Living-donor liver transplantation; DDLT: Deceased-donor liver transplantation.

Table 6 Survival outcomes n (%)

Variable	LDLT (n = 40)	DDLT (n = 80)	P value
Survival status
Alive without relapse	27 (67.5)	51 (63.8)
Alive with disease	3 (7.5)	3 (3.8)
Died of relapse	5 (12.5)	16 (20.0)
Died of other causes	5 (12.5)	10 (12.5)
Overall survival			0.372
1-yr	89.8%	84.9%
5-yr	74.1%	66.6%
Relapse-free survival			0.749
1-yr	81.2%	80.3%
5-yr	72.9%	70.9%

LDLT: Living-donor liver transplantation; DDLT: Deceased-donor liver transplantation.