Salvage liver transplantation for postoperative tumor recurrence or liver dysfunction in patients of hepatocellular carcinoma / 中华普通外科杂志

ABSTRACT

Objective To evaluate salvage liver transplantation(LT)for postoperative tumor recurrence or liver dysfunction in patients of hepatocellular carcinoma(HCC).Methods From April 2001 to March 2006,97 HCC patients with the tumor within Milan Criteria underwent LT as the primary treatment(71 cases)and salvage LT because of after resection tumor recurrence(n=20)or postoperative liver dysfunction(n=6).Perioperative and postoperative parameters and long-term survival were compared between the groups of primary LT and salvage LT.Results The mean age(50.0 years vs.49.7 years),gender,and etiology of liver disease(hepatitis B/C/nonviral)were comparable between the two groups.In the salvage LT group.the mean time between liver resection and LT was 2.50 years.Clinical characteristics such as tumor number(1.37 vs.1.50),operative time(7.92 hours vs.8.56 hours),blood loss (1981.69 ml vs.2626.92 ml)and transfusion(1981.69 ml vs.2626.92 ml)were not statistically different (P＞0.05)between the two groups.The size of largest tumor was significantly different between salvage LT group and the primary LT group(2.81 cm vs.2.05 cm)(t=2.298,P=0.028).By a median follow up of 14.63 months,overall survival after liver transplantation was not different between the 2 groups(X2=0.003.P=0.959).Conclusion In selected patients,liver resection prior to transplantation does not increase the morbidity or impair long.term survival following LT.Therefore.1iver resection prior to transplantation can be integrated with the treatment strategy for HCC.