Liver transplantation for hepatocellular carcinoma: one center's experience, 1987-1994

A retrospective review was done to evaluate the detection of hepatocellular carcinoma preoperatively, using ultrasonography and alpha-fetoprotein in patients awaiting orthotopic liver transplantation. Sixteen of the 187 patients who underwent 209 orthotopic liver transplantations at the Ochsner Transplant Center from 1987 to 1994 were diagnosed with hepatocellular carcinoma, 3 preoperatively and 11 at the time of pathological inspection of the liver explant. Two developed metastatic hepatocellular carcinoma while awaiting orthotopic liver transplantation. Ultrasonography detected abnormalities in the region where hepatoma was identified in 5 of 11 (45%) patients with incidental hepatocellular carcinoma, in all 3 with overt hepatocellular carcinoma, and in neither of the 2 who developed metastatic hepatocellular carcinoma while awaiting orthotopic liver transplantation. Hepatocellular carcinoma was present in 5 of 23 (22%) patients with an alpha-fetoprotein greater than 20 ng/mL and in 3 of 10 (30%) with an alpha-fetoprotein greater than 50 ng/mL.