Evidence map›Paper›PMID 38195107›Full record

ArticleZeitschrift fur Gastroenterologie2024

Liver transplantation for HCC in cirrhosis: Are Milan criteria outdated?

Jan-Paul Gundlach, Mark Ellrichmann, Marieke van Rosmalen, Serge Vogelaar, Christine Eimer, Corinna Rheinbay, Sabina Rösgen, Jost-Philipp Schäfer, Thomas Becker, Michael Linecker and 1 more

Open access · hybridAbstract read
In one paragraph

Article in Zeitschrift fur Gastroenterologie, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.5field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 2 institutions in 2 countries.

Jan-Paul GundlachDepartment of General, Visceral-, Thoracic-, Transplant- and Pediatric-Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.ORCID 0000-0002-8845-6832
Mark EllrichmannInterdisciplinary Endoscopy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.ORCID 0000-0002-5817-5589
Marieke van RosmalenEurotransplantat International Foundation, Leiden, Netherlands.
Serge VogelaarEurotransplantat International Foundation, Leiden, Netherlands.
Christine EimerDepartment of Anesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.
Corinna RheinbayDepartment of General, Visceral-, Thoracic-, Transplant- and Pediatric-Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.
Sabina RösgenDepartment of General, Visceral-, Thoracic-, Transplant- and Pediatric-Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.
Jost-Philipp SchäferClinic for Radiology und Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.
Thomas BeckerDepartment of General, Visceral-, Thoracic-, Transplant- and Pediatric-Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.
Michael Linecker *Department of General, Visceral-, Thoracic-, Transplant- and Pediatric-Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.
Felix Braun *Department of General, Visceral-, Thoracic-, Transplant- and Pediatric-Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.
University Hospital Schleswig-Holstein · DEEurotransplant · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

In Germany, organ allocation is based on the MELD-system and lab-MELD is usually low in patients with hepatocellular carcinoma (HCC) in cirrhosis. Higher medical urgency can be achieved by standard exception for HCC (SE-HCC), if Milan criteria (MC) are met. Noteworthy, UNOS T2 reflects MC, but excludes singular lesions < 2 cm. Thus, SE-HCC is awarded to patients with one lesion between 2 and 5 cm or 2 to 3 lesions between 1 and 3 cm. These criteria are static and do not reflect biological properties of HCC.We present a retrospective cohort of 111 patients, who underwent liver transplantation at UKSH, Campus Kiel between 2007 and 2017. No difference was found in overall survival for patient cohorts using Milan, UCSF, up-to-seven, and French-AFP criteria. However, there was a significantly reduced survival, if microvascular invasion was detected in the explanted organ and in patients with HCC-recurrence. The exclusive use of static selection criteria including MC appear to limit the access to liver transplantation.

Indexed as

Carcinoma, HepatocellularLiver NeoplasmsLiver TransplantationHumansLiver CirrhosisRetrospective Studies

Identifiers

PMID38195107
PMCPMC10776328
OpenAlexW4390780355

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.