Hepatocellular carcinoma and living donor liver transplantation; the factors  associated with recurrence and survival of patients. A single center experience: Hepatosellüler karsinoma ve canlı vericili karaciğer nakli;  kanser nüksü ve hasta sağkalımını etkileyen faktörler. Tek merkez deneyimi

Yusuf Günay; Necdet Güler; Murat Akyıldız; Murat Dayangaç; Onur Yaprak; Yıldıray Yüzer; Yaman Tokat

doi:10.5455/GMJ-30-2013-161

Authors

Yusuf Günay Karaciğer Nakli Merkezi, Florence Nightingale Hastanesi, Şişli, İstanbul
Necdet Güler Karaciğer Nakli Merkezi, Florence Nightingale Hastanesi, Şişli, İstanbul
Murat Akyıldız Karaciğer Nakli Merkezi, Florence Nightingale Hastanesi, Şişli, İstanbul
Murat Dayangaç Karaciğer Nakli Merkezi, Florence Nightingale Hastanesi, Şişli, İstanbul
Onur Yaprak Karaciğer Nakli Merkezi, Florence Nightingale Hastanesi, Şişli, İstanbul
Yıldıray Yüzer Karaciğer Nakli Merkezi, Florence Nightingale Hastanesi, Şişli, İstanbul
Yaman Tokat Karaciğer Nakli Merkezi, Florence Nightingale Hastanesi, Şişli, İstanbul

DOI:

https://doi.org/10.5455/GMJ-30-2013-161

Keywords:

Living donor liver transplantation, hepatocellular carcinoma, hepatocellular carcinoma recurrence

Abstract

Liver transplantation is considered to be the most effective treatment for hepatocellular cancer (HCC) arising in the setting of cirrhosis. However, HCC recurrence remains a concern after liver transplantation. In this study, our goal was to investigate the factors associated with recurrence and survival of the patients after living donor liver transplantation. One hundred and nine patients underwent living donor liver transplantation due to hepatocellular cancer were included in the study. The average age was 55.2±7.82 (26-72) years and 89% of patients were male. Of the 109 patients, 57 (52.3%) met Milan criteria. The mean tumor size was 36.44±22.64 (5-140) mm and 55% of tumor had multifocality. Sixteen (14.7%) patients developed tumor recurrence in a mean follow up of 31.4±26.2 (4-94) months. Tumor size, poor differentiation and hepatitis B recurrence were associated with higher tumor recurrence and lower survival rate. Although tumors outside the Milan criteria were associated with high recurrence, they did not affect survival rate. The survival rate was lower in patients with tumor recurrence. Of the 109 patients, 87 (75.2%) were alive while 27 (24.8%) were deceased. The overall survival rates at first year in patients with recurrence and without recurrence were 54.27±12.89% and 85.54±4.36% respectively. In conclusion, tumor recurrence decreases patients survival rate after living donor liver transplantation performed for HCC. In order to predict both tumor recurrence and patient survival, all other tumor characters should be evaluated with the Milan criteria prior to transplantation.

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