LIVER-TRANSPLANTATION FOR HEPATOCELLULAR-CARCINOMA

Twenty-nine patients with hepatocellular carcinoma (HCC) underwent ort hotopic liver transplantation (OLTx) at the University of Toronto. Fou r patients did not have cirrhosis. Of the 25 patients with cirrhosis, 19 had known or suspected HCC before OLTx. Eleven patients tested posi tive for the hepatitis B surface antigen (HBsAg). No patients received adjuvant chemotherapy. None of the patients have developed recurrent HCC in a follow-up of 9 to 87 months (mean: 33 months). The actuarial post-transplant survival of all patients at 3 months, 1 year and 3 yea rs was 75%, 61%, and 46%, respectively. The survival of HBsAg-negative patients was 69% at 3 years, whereas HBsAg-negative patients had a 3- year survival of 18% (p = 0.045). These results suggest that OLTx for carefully selected patients with otherwise unresectable HCC is associa ted with a low risk of recurrence. HBsAg-positive patients with HCC ha ve a high mortality, suggesting that they make poor candidates for OLT x.