title: Liver transplantation for hepatocellular carcinoma.
abstract: Twenty-nine patients with hepatocellular carcinoma (HCC) underwent orthotopic liver transplantation (OLTx) at the University of Toronto. Four patients did not have cirrhosis. Of the 25 patients with cirrhosis, 19 had known or suspected HCC before OLTx. Eleven patients tested positive 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 years 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 associated with a low risk of recurrence. HBsAg-positive patients with HCC have a high mortality, suggesting that they make poor candidates for OLTx.
authors.affiliation: Department of Surgery, University of Toronto, Canada.
authors.forename: S W
authors.initials: SW
authors.lastname: Chung
authors.forename: J L
authors.initials: JL
authors.lastname: Toth
authors.forename: M
authors.initials: M
authors.lastname: Rezieg
authors.forename: R
authors.initials: R
authors.lastname: Cameron
authors.forename: B R
authors.initials: BR
authors.lastname: Taylor
authors.forename: P D
authors.initials: PD
authors.lastname: Greig
authors.forename: G A
authors.initials: GA
authors.lastname: Levy
authors.forename: B
authors.initials: B
authors.lastname: Langer
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006509:Hepatitis B / Q000097:blood / Q000150:complications; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications; D008113:Liver Neoplasms / Q000150:complications / Q000401:mortality / Q000601:surgery*; D016031:Liver Transplantation / Q000379:methods / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012008:Recurrence; D016019:Survival Analysis
chemical_list: D006514:Hepatitis B Surface Antigens