Akademik Veri Yönetim Sistemi
Hepatoma research, cilt.6, sa.11, ss.1-10, 2020 (Scopus)
Abstract
Aim: We aimed to study the clinical and pathological characteristics of liver transplant recipients with hepatocellular
carcinoma recurrence.
Methods: We reviewed the data for 26 patients who had tumor recurrence after deceased donor liver transplant for
hepatocellular carcinoma at the Johns Hopkins Hospital from January 2005 to December 2015.
Results: In total, 88% of recipients were males. The mean age was 59 years. On explant, poor differentiation was
detected in 43%, while 73% had microvascular invasion. Overall, 62% were diagnosed to be outside of Milan criteria.
Out of these, 15% met the criteria for downstaging. Twenty (77%) patients had pre-transplant alpha fetoprotein levels
≥ 20 ng/mL. In 54% of patients, the location of hepatocellular carcinoma (HCC) recurrence was extrahepatic, followed
by intrahepatic in 31% and both intra- and extrahepatic in 15%. The post-transplant tumor recurrence was diagnosed
at a mean of 427 days (range 34-1502). Fifty percent of HCC recurrences were diagnosed within one year following
liver transplant. Twenty (77%) patients received treatment for their recurrent HCC: external radiation (n = 10), surgical
resections (n = 8; brain 4, spine 2, bone 1, and Whipple surgery 1), sorafenib (n = 7), locoregional therapy (n = 5).
Overall, 24 out of 26 (92%) recipients died within four years after the transplant.
Conclusion: HCC recurrence after liver transplant is infrequent. More than fifty percent of HCC recurrences following
liver transplant are extrahepatic. Despite better recipient selection for liver transplant, the curative options are limited in
recurrent cases and associated with extremely poor outcomes.