Hepatocellular carcinoma experience of Florence Nightingale Hospital Liver Transplantation Unit

Abstract

Objectives: The aim of this study is to evaluate the results of the patients with Hepatocellular carcinoma (HCC), who underwent liver transplantation.
Patients and methods: Between 2004 and 2015, a total of 841 patients underwent liver transplantation. Out of these patients, 192 patients (20%)
were deceased donor liver transplantations and 649 patients (80%) were living donor liver transplantation. All patients who were diagnosed with HCC were indentified (n=220). The clinical characteristics, pre-, intra- and postoperative data, graft and patients survival were retrospectively reviewed. The results were statistically analyzed.
Results: There were 220 patients in the age of 58 years (IQR 53-61 who underwent liver transplantation for HCC. Of these patients, 54 patients (24%) were deceased donor liver transplantation and 166 patients (76%) were living donor liver transplantation. The median lab-MELD-score was 12 (IQR 9-17). The median AFP value was 27 ng/mL (IQR 7-109). The Milan criteria were met in 139 patients (64%). Outside Milan criteria were 81 patients (36%). The pathology report has shown cholangiocellular carcinoma (CCC) in three patients (1%), mixed HCC + CCC in seven patients (4%) and pure HCC in 210 patients (95%). Perioperative death was seen 14 patients (6%). Recurrent disease occurred in 43 patients (19%). The overall one year survival was 89% and the five-year survival was 76%.
Conclusion: Based on the results of our study we can conclude that liver transplantation is the treatment of choice for HCC in cirrhosis with an excellent potential to cure the disease, if the patients is well selected with low AFP value without vascular invasion.