Liver transplantation as a treatment for hepatocellular carcinoma - V1

• Research type

  Research Study

• Full title

  Liver transplantation as treatment for patients with hepatocellular carcinoma; a study using existing electronic data.

• IRAS ID

  218152

• Contact name

  David Wallace

• Contact email

  david.wallace@lshtm.ac.uk

• Sponsor organisation

  London School of Hygiene & Tropical Medicine

• Duration of Study in the UK

  2 years, 11 months, 26 days

• Research summary

  Background:
  Hepatocellular carcinoma (HCC) is the most common liver cancer. The incidence of HCC has increased four-fold in the last 30 years with over 4000 people now diagnosed each year in the UK. Overall survival of in patients with HCC is poor with less than 30% alive one year after diagnosis.

  Liver transplantation is increasingly being used as a treatment for patients with HCC and cholangiocarcinoma leading to an increasing gap between the number of patients waiting for liver transplantation and the availability of suitable livers. In response, the transplant centres have started to use more and more livers from donors after cardiac death (DCD), accepting that transplant outcomes with livers from these donors are a slightly worse than with livers from the more conventional brainstem death donors (DBD).

  Aims:
  The overall aim of my research is to improve the role that liver transplantation can play as a treatment for patients with HCC. I have 5 specific objectives:

  1. Identify the rising incidence and mortality of HCC in England and worldwide

  2. Assess the validity of the linked national databases as a data source for
  HCC research

  3. Identify the impact of sociodemographic and clinical factors on treatment selection and survival of
  patients with HCC and cholangiocarcinoma.

  4. Identify the outcomes of liver transplantation in patients with HCC

  5. Identify the outcomes of liver transplantation in patients with HCC who receive a cardiac death donor
  liver

  Design:
  I will use patient records available in three national databases: the National Cancer Registration and Analysis (NCRAS) database, the Hospital Episode Statistics (HES) linked to ONS database and the UK Liver Transplant (UKLT) database to evaluate the outcome of transplantation in HCC patients. These patient records will be linked so that I can use for individual patients the unique information that each database contains.

• REC name

  London - Brighton & Sussex Research Ethics Committee

• REC reference

  17/LO/0231

• Date of REC Opinion

  10 Feb 2017

• REC opinion

  Favourable Opinion