Results of liver transplantation in case of hepatocellular carcinoma

Hepatocellular carcinoma is the most common type of malignant liver tumor. The article presents the experience of liver transplantation at the National Scientific Center of Surgery named after. A.N. Syzganov in patients with HCC.

Purpose:

To evaluate the results of liver transplantation in case of HCC.

Materials and methods:

A retrospective and prospective study for the period from 2011 to 2018 includes 112 patients with chronic liver disease who underwent liver transplantation on the basis of the department of hepatobiliary surgery and liver transplantation. From this, 86 cases of liver transplantation were carried out from a live donor liver transplantation (LDLT), while 14 patients (DDLT) performed liver transplantation from a post-mortem donor. In 7 cases, patients were diagnosed with HCC, in 3 cases the morphological verification of the diagnosis of HCC was determined after transplantation (Table 1).

Results:

The mean value of alfa-fetoprotein (AFP) was 657.05 (2.35 – 3465) ng/ml, of which only 3 patients' AFP was higher than normal, and 4 patients' AFP was in normal limits. HBV + HDV is diagnosed in 3 cases, in 3 recipientspositive HCV is detected, whereas in 1 case HBV (Table 2). The average tumor size was 3.01 (1.0 – 5.5)cm. TACE was performed in two patients before the operation. In 2 cases, taking into account the high AFP values ≥1000 and 3465 ng/ml, a bypass system was used in performing hepatectomy. The histological material after transplantation corresponded to hepatocellular carcinoma, with predominance of the trabecular type of HCC. The lethal outcome was in one case due to a vascular complication in the early postoperative period.

Conclusion:

Despite the small number of patients, the results obtained by us testify to the high efficiency of liver transplantation in patients with HCC.