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In regions with a limited deceased donor pool, living donor adult liver transplantation has become an important treatment modality for patients with hepatocellular carcinoma and cirrhosis.
Studies have shown higher recurrence rates of hepatocellular carcinoma after living donor adult liver transplantation in comparison with deceased donor liver transplantation.
Dr Elizabeth Pomfret and colleagues examined the outcome results and recurrence rates for patients with hepatocellular carcinoma who underwent living donor adult liver transplantation at their center.
During an 8-year period, 139 patients underwent living donor adult liver transplantation, of whom 28 had hepatocellular carcinoma in their explanted livers.
The median follow-up was 41 months.
 | | The mean explant tumor size was 3 | | Hepatology |
The mean explant tumor size was 3, and the mean number of tumors was 2.
The research team found that 75% of patients had tumors within the Milan criteria.
The team noted that 5 patients had tumors outside the Milan criteria but within the University of California San Francisco (UCSF) criteria, and 2 patients were beyond the UCSF criteria.
The overall 1- and 5-year patient and graft survival rates were 96% and 81%, respectively.
Survival following living donor adult liver transplantation was significantly better than survival following deceased donor liver transplantation for hepatocellular carcinoma during the same time period.
The research team noted that 29% of patients developed tumor recurrence.
Dr Pomfret's team concludes, "Poor differentiation of tumor cells was the most significant determinant of recurrence."
"Despite high recurrence rates of hepatocellular carcinoma following living donor adult liver transplantation, overall 5-year survival appears to be excellent."
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