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Postoperative surveillance with monthly serum tumor markers after living‐donor liver transplantation for hepatocellular carcinoma
Author(s) -
Yamashiki Noriyo,
Sugawara Yasuhiko,
Tamura Sumihito,
Tateishi Ryosuke,
Yoshida Haruhiko,
Kaneko Junichi,
Matsui Yuichi,
Togashi Junichi,
Akahane Masaaki,
Makuuchi Masatoshi,
Omata Masao,
Kokudo Norihiro
Publication year - 2010
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/j.1872-034x.2009.00591.x
Subject(s) - medicine , hepatocellular carcinoma , milan criteria , liver transplantation , gastroenterology , tumor marker , magnetic resonance imaging , prothrombin time , transplantation , radiology , cancer
Aim: Recurrence of hepatocellular carcinoma (HCC) after liver transplantation decreases patient survival. The usefulness of post‐transplant surveillance with tumor markers, however, is not clear. We evaluated our cumulative experience with recurrent HCC detected during post‐transplant surveillance. Methods: We analyzed 100 patients with HCC detected in the explanted liver. Monthly to bimonthly measurement of tumor markers and yearly computed tomography were scheduled postoperatively. Results: Preoperatively, 82 met the Milan criteria. The histological findings indicated that 61 fulfilled the Milan criteria. In nine patients, HCC recurred 10 months (2–29) after liver transplantation in the graft ( n = 1), lung ( n = 2), bone ( n = 3) and multiple organs ( n = 3). In all nine recipients, HCC was first suspected based on an increase in tumor marker levels. Recurrent HCC was confirmed by computed tomography ( n = 7) or magnetic resonance imaging ( n = 2) within 4 months (0–6) after first identifying an increase in the tumor marker levels. Six cases were treated surgically, two of which achieved prolonged survival of 16 and 38 months. Conclusion: Frequent measurement of α‐fetoprotein and des‐γ carboxy prothrombin was useful for detecting recurrent HCC and may be useful long‐term follow‐up markers for post‐transplant surveillance.