Small-sized liver graft does not increase the risk of hepatocellular carcinoma recurrence after living donor liver transplantation.
OBJECTIVE
Following implantation into adult recipients, living donor liver grafts usually undergo liver regeneration. This regeneration process may provoke the growth of occult hepatocellular carcinoma (HCC) cells in the recipient body. To assess the risk of HCC recurrence, we analyzed the influence of graft-recipient weight ratio (GRWR).


METHODS
The 181 recipients with HCC within the University of California at San Francisco (UCSF) criteria were divided into four groups according to GRWR: low GRWR (<0.8; n = 30), mid GRWR (0.8-1.0; n = 65), high GRWR (>1.0; n = 64), and whole liver graft group (>1.5; n = 22).


RESULTS
There were no differences in overall patient survival (P = .105) and recurrence-free survival (P = .406) among these four groups. GRWR <0.8 was not a significant risk factor for HCC recurrence. Similar outcomes were obtained in HCC patients who met the Milan criteria (n = 170).


CONCLUSIONS
We think that small living donor liver graft and subsequent liver regeneration do not increase the risk of posttransplant HCC recurrence when HCC is within the Milan or UCSF criteria.
Hwang
S
S
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Poongnap-Dong, Seoul 138-736, Republic of Korea.
Lee
S G
SG
Ahn
C S
CS
Kim
K H
KH
Moon
D B
DB
Ha
T Y
TY
Park
K M
KM
Song
G W
GW
Jung
D H
DH
Kim
B S
BS
Moon
K M
KM
D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D008099:Liver / Q000033:anatomy & histology*; D008113:Liver Neoplasms / Q000401:mortality / Q000601:surgery*; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D009929:Organ Size; D012189:Retrospective Studies; D016019:Survival Analysis