Korean J Transplant.  2023 Nov;37(Suppl 1):S269. 10.4285/ATW2023.F-8738.

A small-volume center experience of liver transplantation for the patients with hepatocellular carcinoma

• Kim TS
• Kim M
• Ahn KS
• Kim YH
• Kang KJ

• KMID: 2551898
• DOI: http://doi.org/10.4285/ATW2023.F-8738

Abstract

Background
Liver transplantation (LT) has been established as a best treatment in selected hepatocellular carcinoma (HCC) patients. However, most of LT for patients with HCC have been performed mainly in large-volume centers. In here, we introduce the experiences of LT for patients with HCC in small-volume center.
Methods
A total of 43 HCC patients who underwent LT between January 2010 and February 2023 were included in this study. We reviewed the medical records of these patients retrospectively and analyzed the outcomes.
Results
The mean follow-up period was 53.9 months and there was one perioperative mortality case. About 58% of patients met Milan criteria (MC) and 42% of patients presented beyond MC. The overall survival rates in 1-, 3-, and 5-year were 90%, 82%, and 73%, respectively. The recurrence-free survival rates in 1-, 3-, and 5-year were 98%, 82%, and 78%, respectively. The recurrence-free survival was significantly better in patients who met the Milan and University of California San Francisco (UCSF) criteria; however, the overall survival was not statistically different according to the Milan and UCSF criteria. Among these patients, recurrences were occurred in seven patients. The site of recurrence was lung in three patients, intraperitoneal space (omentum, peritoneum, and abdominal wall) in three patients, graft liver in three patients and lymph nodes in two patients. Recurred mass was resectable in three patients and these patients have been followed up healthy without further recurrence after resection.
Conclusions
The outcome of LT for HCC patients in small-volume center was comparable with high-volume center. If the recurrent tumor would be resectable, resection can be a good treatment option for long-term survival.