Open AccessLong‐term observation of hepatocellular carcinoma recurrence after liver transplantation at a European transplantation centre
Author(s) -
Foerster Friedrich,
Hoppe-Lotichius Maria,
Vollmar Johanna,
Marquardt Jens U,
Weinmann Arndt,
Wörns Marcus-Alexander,
Otto Gerd,
Zimmermann Tim,
Galle Peter R
Publication year - 2019
Publication title -
ueg journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.667
H-Index - 35
eISSN - 2050-6414
pISSN - 2050-6406
DOI - 10.1177/2050640619840221
Subject(s) - medicine , hepatocellular carcinoma , liver transplantation , milan criteria , transplantation , pathological , economic shortage , gastroenterology , surgery , carcinoma , linguistics , philosophy , government (linguistics)
Background The recurrence of hepatocellular carcinoma (HCC) is the strongest survival‐limiting factor after liver transplantation (LT) in patients with HCC. In the face of donor organ shortage, it is necessary to identify factors associated with HCC recurrence in order to maximize the utility of the available grafts. Objective To study the phenomenon of HCC recurrence after LT at a European transplantation centre over the past 20 years. Methods Data from 304 HCC patients who underwent LT were prospectively recorded. Clinical and pathological factors were assessed for their association with recurrence. Results Fifty‐one patients (16.8%) had HCC recurrence after LT. Patients exceeding the Milan criteria developed HCC recurrence more frequently. The time point of recurrence did not affect survival after recurrence. Furthermore, there was no difference in survival between patients with intra‐ and extrahepatic recurrence. However, patients with recurrence due to needle tract seeding had a significantly better outcome than patients with other sites of recurrence. Conclusion Our data support a restrictive use of patient selection criteria to help identify patients who have an increased risk of HCC recurrence after LT, and highlight the need to improve patient selection before LT in order to minimize the rate of HCC recurrence.