Total XXXX volume and @entity160 for selection of transplant candidates with @entity157 : A prospective validation.

@entity1 @entity157 @entity160 @entity5
UNASSIGNED: The selection of liver transplantation (LT) candidates with @entity157 ( @entity157 ) is currently validated based on Milan criteria. The use of extended criteria has remained a matter of debate, mainly because of the absence of prospective validation. The present prospective study recruited @entity1 according to the previously proposed total @entity5 volume (TTV;  <=115 cm(3) )/ @entity160 ( @entity160 ;  <=400 ng/mL) score. @entity1 with @entity160 >400 ng/mL were excluded, and, as such, the Milan group was modified to include only @entity1 with @entity160 <400 ng/mL; these @entity1 were compared to @entity1 beyond Milan, but within TTV/ @entity160 . From January 2007 to March 2013, 233 @entity1 with @entity157 were listed for LT. Of them, 195 @entity1 were within Milan and 38 beyond Milan, but within TTV/ @entity160 . The average follow-up from listing was 33.9    24.9 months. Risk of dropout was higher for @entity1 beyond Milan, but within TTV/ @entity160 (16 of 38; 42.1%), than for those within Milan (49 of 195 [25.1%]; P = 0.033). In parallel, intent-to-treat survival from listing was lower in @entity1 beyond Milan (53.8% vs. 71.6% at 4 years; P < 0.001). After a median waiting time of 8 months, 166 @entity1 were transplanted, 134 within Milan criteria, and 32 beyond Milan but within TTV/ @entity160 . They demonstrated acceptable and similar recurrence rates (4.5% vs. 9.4%; P = 0.138) and post-transplant survivals (78.7% vs. 74.6% at 4 years; P = 0.932). CONCLUSION: Based on the present prospective study, @entity157 LT candidate selection could be expanded to the TTV ( <=115 cm(3) )/ @entity160 ( <=400 ng/mL) criteria in centers with at least 8-month waiting time. An increased risk of dropout on the waiting list can be expected, but with equivalent and satisfactory post-transplant survival. (Hepatology 2015).
