title: Results of liver transplantation for hepatocellular cancer.
abstract: BACKGROUND
  Liver transplantation (LTx) for hepatocellular carcinoma (HCC) in cirrhotic liver is nowadays generally accepted treatment modality.
  
  
  OBJECTIVE
  Overview of the indications and results of the LTx in the patients with HCC, the first one performed in 2001.
  
  
  METHODS
  Among 357 adult liver transplant recipients in the period 1994-04.2005, in 26 (7%) the indication was HCC (16 men: 10 women, age 20-65, mean 46.5 years). HCC developed in cirrhotic liver in 25 pts. 12 (48%) were Child C, 10 (30%)--Child B and 3 (12%)--Child A patients. As underlying disease in 2 patients (8%) was alcoholic cirrhosis, in 7 (28%)--HBV cirrhosis, in 12 (48%)--HCV cirrhosis and in 4 (16%)--HBV/HCV cirrhosis. Milano criteria were met in 20 patients (77%). The mean waiting list time was 2.9 months (range 1-6 months). Seven patients underwent liver resection and 1 transarterial chemoembolization prior to LTx. 11 patients (42%) were operated on with use of veno-venous bypass, in 15 patients (58%) the piggy back technique was applied. Rapamycine based immunosuppression was preferred in post-LTx treatment.
  
  
  RESULTS
  Operative mortality was 0.4 patients required relaparotomy for intraperitoneal bleeding. 21 patients (81%) are alive in good general condition, 19--free of the disease. 5 patients died 7-28 months after LTx (mean 16.7). The mean survival time is 20 months (range 1-38).
  
  
  CONCLUSIONS
  Liver transplantation is safe and effective method of treatment of the selected patients with HCC in cirrhotic liver. Further investigations concerning the precise indications, timing of the transplantation and adjuvant treatment are necessary.
authors.affiliation: Department of General, Transplant & Liver Surgery, Medical University of Warsaw, Poland. kzienie@amwaw.edu.pl
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Zieniewicz
authors.forename: Waldemar
authors.initials: W
authors.lastname: Patkowski
authors.forename: Paweł
authors.initials: P
authors.lastname: Nyckowski
authors.forename: Abdulsalam
authors.initials: A
authors.lastname: Alsharabi
authors.forename: Bogdan
authors.initials: B
authors.lastname: Michałowicz
authors.forename: Jacek
authors.initials: J
authors.lastname: Pawlak
authors.forename: Rafał
authors.initials: R
authors.lastname: Paluszkiewicz
authors.forename: Tadeusz
authors.initials: T
authors.lastname: Wróblewski
authors.forename: Bogusław
authors.initials: B
authors.lastname: Najnigier
authors.forename: Piotr
authors.initials: P
authors.lastname: Smoter
authors.forename: Piotr
authors.initials: P
authors.lastname: Hevelke
authors.forename: Anna
authors.initials: A
authors.lastname: Skwarek
authors.forename: Piotr
authors.initials: P
authors.lastname: Remiszewski
authors.forename: Marcin
authors.initials: M
authors.lastname: Kotulski
authors.forename: Michał
authors.initials: M
authors.lastname: Skalski
authors.forename: Leszek
authors.initials: L
authors.lastname: Paczek
authors.forename: Marek
authors.initials: M
authors.lastname: Krawczyk
mesh_terms: D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000209:etiology / Q000401:mortality* / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications; D008113:Liver Neoplasms / Q000209:etiology / Q000401:mortality* / Q000601:surgery*; D016031:Liver Transplantation / Q000401:mortality / Q000592:standards; D008297:Male; D008875:Middle Aged; D040841:Resource Allocation / Q000639:trends; D015996:Survival Rate; D016896:Treatment Outcome