Recurrence of HCC after living donor liver transplantation, retrospective cohort study of a single centre experience.

Articles in Press

Document Type : Original Article

Authors

1 Department of surgery /Faculty of medicine /Minia university Egypt

2 Maddi Armed Forces HPB and Liver Transplant, Cairo, Egypt

Abstract

Background: Hepatocellular carcinoma is one of the leading causes of death worldwide. Therefore, liver transplantation is generally regarded as the ideal treatment.

Methods: Between 2010 and 2016, patients who presented with HCC with or without end stage liver disorder and treated with liver transplantation were retrospectively analyzed to assess for recurrence and its prognostic factors.

Results: Fifty-nine with HCC were treated by liver transplantation and included in the study. Recurrent HCC detected in 15 patients of 59 cases and was most common in the liver in the first two years. The rate of death among cases with recurrent mortality was 60%. Overall survival at 1 year, 3 years and 5 years was 94.9 percent, 78 percent and 74.5 percent respectively. Cumulative recurrence free survival at one year, three years and 5 years was 88.1 percent, 64.5 percent and 62.7 percentrespectively. Patients with AFP level < 200 ng/ml were having better recurrence free survival than patients with ≥ 200 ng /ml. Milan Criteria was not statistically significant regarding recurrence or overall survival.

ConclusionsHepatocellular carcinoma recurrence is a frequent occurrence following liver transplantation, and the prognosis isn’t favorable. The occurrence of high preoperative AFP and microvascular invasion are adverse prognostic factors. Preoperative ablative therapy seems to improve recurrence free survival but not overall survival. Milan criteria should be validated and a new model for selection of patients with HCC for liver transplantation; considering not only the morphological characteristics of the tumour but also its biological behavior, should be developed.

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Minia Journal of Medical Research

Articles in Press, Accepted Manuscript
Available Online from 30 October 2024

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