Korean J Transplant.  2022 Nov;36(Supple 1):S388. 10.4285/ATW2022.F-5268.

Long term outcome of hepatocellular carcinoma managed with an elective living donor liver transplantation strategy in high volume center

• Sreekumar S
• Gupta S
• Agarwal S
• Dey R

• KMID: 2535216
• DOI: http://doi.org/10.4285/ATW2022.F-5268

Abstract

Patients with hepatocellular carcinoma (HCC) in chronic liver disease (CLD) awaiting deceased donor liver transplantation may progress or decompensate. Living donor liver transplantation (LDLT) offers an elective strategy for them and more so after downstaging in a locally advanced HCC. We compared the long-term outcome following LDLT for HCC in chronic liver disease (CLD) in Milan criteria, University of California San Francisco (UCSF) criteria and outside UCSF criteria. It is a retro-prospective study done by analyzing the long-term outcome of patients managed with LDLT for HCC in CLD during the study period from 2006–2022 viz disease-free survival and recurrence rates with a minimum follow-up 6 months. During the study period a to-tal of 3,538 LDLT were performed out of which 554 LDLT were performed for HCC. A total of 56 patients were lost to follow-up. Hence, 498 LDLT patients were included in the study, of which 87 patients underwent LDLT after downstaging. The 5-year and 10-year overall survival was 81.08% and 63.08% respectively. Among the patient who underwent downstaging the 5-year sur-vival was 73.5% and recurrence occurred in 10.3% patients. The number of patients within Milan criteria, UCSF criteria (outside Milan criteria) and outside UCSF criteria were 73.09% (364), 20.28% (101) and 6.6% (33). The overall recurrence rate among all the groups were 8.52% (excluding 52 patients who had 30-day mortality). The recurrence rate among Milan criteria, UCSF cri-teria (outside Milan criteria) and outside UCSF criteria were 5.2%, 14.8% and 12.12% respectively. LDLT for HCC with CLD has an excellent outcome in those within UCSF criteria and outside UCSF criteria after adequate downstaging.