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      Retraction: Salvage Liver Transplantation for Recurrent Hepatocellular Carcinoma after Liver Resection: Retrospective Study of the Milan and Hangzhou Criteria

      retraction
      The PLOS ONE Editors
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          Abstract

          Concerns have been raised that the transplants performed in the local context at the time of procedures reported in this article [1] may have involved organs/tissues procured from prisoners [2]. Details as to the donor sources and methods of obtaining informed consent from donors were not reported in this article [1], and when following up on these concerns the authors did not clarify these issues or the cause(s) of donor death in response to journal inquiries. International ethical standards call for transparency in organ donor and transplantation programs and clear informed consent procedures including considerations to ensure that donors are not subject to coercion [3,4,5]. The authors state that no vulnerable populations were involved in their research and all organs were obtained voluntarily but did not provide ethics approval documentation or consent forms to support their claim or clarify whether organs had been procured from prisoners. The authors did not respond to inquiries about the availability of underlying data supporting this study. Owing to the lack of documentation to demonstrate this study had prospective ethical approval, insufficient reporting, unresolved concerns around the source of transplanted organs and whether they included organs from prisoners, and in compliance with international ethical standards for organ/tissue donation and transplantation, the PLOS ONE Editors retract this article. The corresponding author notified the journal that all authors disagree with the retraction. The other authors either could not be reached or did not respond directly.

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          Most cited references3

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          WHO guiding principles on human cell, tissue and organ transplantation.

          (2010)
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            Compliance with ethical standards in the reporting of donor sources and ethics review in peer-reviewed publications involving organ transplantation in China: a scoping review

            The objective of this study is to investigate whether papers reporting research on Chinese transplant recipients comply with international professional standards aimed at excluding publication of research that: (1) involves any biological material from executed prisoners; (2) lacks Institutional Review Board (IRB) approval and (3) lacks consent of donors. Scoping review based on Arksey and O’Mallee’s methodological framework. Medline, Scopus and Embase were searched from January 2000 to April 2017. We included research papers published in peer-reviewed English-language journals reporting on outcomes of research involving recipients of transplanted hearts, livers or lungs in mainland China. Data were extracted by individual authors working independently following training and benchmarking. Descriptive statistics were compiled using Excel. 445 included studies reported on outcomes of 85 477 transplants. 412 (92.5%) failed to report whether or not organs were sourced from executed prisoners; and 439 (99%) failed to report that organ sources gave consent for transplantation. In contrast, 324 (73%) reported approval from an IRB. Of the papers claiming that no prisoners’ organs were involved in the transplants, 19 of them involved 2688 transplants that took place prior to 2010, when there was no volunteer donor programme in China. The transplant research community has failed to implement ethical standards banning publication of research using material from executed prisoners. As a result, a large body of unethical research now exists, raising issues of complicity and moral hazard to the extent that the transplant community uses and benefits from the results of this research. We call for retraction of this literature pending investigation of individual papers.
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              Salvage Liver Transplantation for Recurrent Hepatocellular Carcinoma after Liver Resection: Retrospective Study of the Milan and Hangzhou Criteria

              Background Salvage liver transplantation (SLT) has recently been proposed for recurrent hepatocellular carcinoma after liver resection; however, criteria for candidate assessment in SLT have not been thoroughly evaluated. Methods and Findings We retrospectively analyzed outcomes and factors affecting survival of 53 recipients who received SLT in the Liver Transplantation Center, The First Affiliated Hospital of Zhejiang University between 2004 and 2012. Thirty recipients fulfilled the Hangzhou criteria, of which 16 also fulfilled the Milan criteria, while the remaining 23 exceeded both criteria. The 1-year, 3-year and 5-year overall survival rates and tumor-free survival rates were both superior in patients fulfilling Milan or Hangzhou criteria compared with those exceeding the criteria. For recipients outside Milan criteria but within Hangzhou criteria, the 1-year, 3-year overall survival rates were 70.1%, 70.1%, similar to recipients within Milan criteria, with the 1-year, 3-year and 5-year overall survival of 93.8%%, 62.1% and 62.1% (P = 0.586). The tumor-free survival rates were also similar between these two subgroups, with 51.9% and 51.9% vs. 85.6%, 85.6% and 64.2% during the same time interval, respectively (P = 0.054). Cox regression analysis identified Hangzhou criteria (within vs. outside, hazard ratio (HR) 0.376) and diameter of the largest tumor (HR 3.523) to be independent predictors for overall survival. The only predictor for tumor-free survival was diameter of the largest tumor (HR 22.289). Conclusions Hangzhou criteria safely expanded the candidate pool and are feasible in assessment of candidates for SLT. This is helpful in donor liver allocation in transplant practice.
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                Author and article information

                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                23 July 2019
                2019
                23 July 2019
                : 14
                : 7
                : e0220431
                Article
                PONE-D-19-20187
                10.1371/journal.pone.0220431
                6650067
                31335877
                a94f1829-13fb-4326-a18f-1ac8564566e5
                © 2019 The PLOS ONE Editors

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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                Categories
                Retraction
                Science Policy
                Research Integrity
                Publication Ethics
                Social Sciences
                Law and Legal Sciences
                Criminal Justice System
                Prisons
                Prisoners
                Medicine and Health Sciences
                Surgical and Invasive Medical Procedures
                Transplantation
                Organ Transplantation
                Medicine and Health Sciences
                Surgical and Invasive Medical Procedures
                Digestive System Procedures
                Liver Transplantation
                Medicine and Health Sciences
                Surgical and Invasive Medical Procedures
                Transplantation
                Organ Transplantation
                Liver Transplantation
                Medicine and Health Sciences
                Oncology
                Cancers and Neoplasms
                Carcinomas
                Hepatocellular Carcinoma
                Medicine and Health Sciences
                Oncology
                Cancers and Neoplasms
                Gastrointestinal Tumors
                Hepatocellular Carcinoma
                Medicine and Health Sciences
                Gastroenterology and Hepatology
                Liver Diseases
                Hepatocellular Carcinoma
                Medicine and Health Sciences
                Surgical and Invasive Medical Procedures
                Digestive System Procedures
                Hepatic Resection
                Medicine and Health Sciences
                Surgical and Invasive Medical Procedures
                Surgical Resection
                Hepatic Resection
                Research and Analysis Methods
                Research Design
                Retrospective Studies

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