Living-donor liver transplantation for hepatocellular carcinoma

The current status of cadaveric liver transplantation in Japan and our experience with living-donor liver transplantation for patients with hepatocellular carcinoma are described. At Shinshu University, we performed 137 living-donor liver transplantations on 137 patients, including 80 pediatric and 57 adult patients, between June 1990 and November 2000. The survival rates for these patients are 87% at 1 year and 84% at 5 years. Of these 137, eight had hepatocellular carcinoma. Only one patient had a solitary tumor while in the remaining seven patients, the tumors were multiple, ranging in number from 2 to 11. The maximum tumor size was within the range 14 to 45 mm, and six out of the eight were Stage III or IVa. With a follow-up ranging from 2 to 119 months, two patients died, one patient had recurrence while the remaining are all alive and disease-free. These data, due to the relatively short follow-up and the small number of cases, do not allow us to draw any valuable conclusions about the effectiveness of living-donor liver transplantation in the treatment of hepatocellular carcinoma. However, in consideration of the worldwide recognized good therapeutic efficacy of liver transplant from cadaveric donors in the treatment of hepatocellular carcinoma and also the relatively advanced stage of the disease in the present series, these preliminary results seem promising.