Liver transplantation for hepatocellular carcinoma

Area of Science:

• Hepatology
• Transplantation Surgery
• Oncology

Background:

• Hepatocellular carcinoma (HCC) is a leading cause of cancer death worldwide.
• Orthotopic liver transplantation (OLTx) is a potential curative option for unresectable HCC.
• Patient selection and outcomes, particularly in relation to hepatitis B virus (HBV) infection, require further investigation.

Purpose of the Study:

• To evaluate the outcomes of OLTx in patients with HCC.
• To assess the recurrence rates and survival post-OLTx.
• To determine the impact of hepatitis B surface antigen (HBsAg) status on transplant outcomes.

Main Methods:

• Retrospective analysis of 29 patients with HCC undergoing OLTx.
• Data collection on patient demographics, HCC characteristics, and HBsAg status.
• Survival and recurrence rates were analyzed over a mean follow-up of 33 months.

Main Results:

• No HCC recurrence was observed in any patient during the follow-up period (9-87 months).
• Overall 3-year actuarial survival was 46%.
• HBsAg-negative patients demonstrated significantly better 3-year survival (69%) compared to HBsAg-positive patients (18%, p=0.045).

Conclusions:

• OLTx is a viable treatment for carefully selected HCC patients with a low risk of recurrence.
• HBsAg-positive HCC patients are associated with high mortality and may not be suitable candidates for OLTx.
• HBsAg status is a critical prognostic factor influencing survival after OLTx for HCC.