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Comment & Response
December 15, 2021

Benefit of a Live Donor for Patients With Hepatocellular Carcinoma on the Waiting List—Reply

Author Affiliations
  • 1Institut de Recherche Clinique, Université Catholique de Louvain, Brussels, Belgium
  • 2General Surgery and Organ Transplantation Unit, Department of General 3 Surgery and Organ Transplantation, Sapienza University of Rome, Rome, Italy
  • 3Abdominal Transplant and HPB Surgical Oncology, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada
JAMA Surg. 2022;157(4):356-357. doi:10.1001/jamasurg.2021.6373

In Reply We thank Zhang et al for their Letter on our article1 on the beneficial intention-to-treat effect of living donor liver transplant (LDLT) when compared with deceased donor liver transplant (DDLT) in the setting of patients with hepatocellular cancer (HCC).

Zhang et al stated that owing to the significant differences between the Eastern and the Western worlds, a head-to-head comparison of LDLT vs DDLT activities performed in the same center instead of a comparison among international centers should be a better way for comparison accurately evaluating the intention-to-treat survival benefit of live donation. We fully agree with this sentence. Our study was designed to evaluate both (1) an international activity in which centers polarized to an (almost) exclusive DDLT or LDLT activity were enrolled and (2) a single-center activity in which both the experiences are commonly done.

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