title: Salvage liver transplantation for recurrent hepatocellular carcinoma after liver resection: feasibility of the Milan criteria and operative risk.
abstract: BACKGROUND
  Although the Milan criteria are widely accepted for liver transplantation (OLT) for hepatocellular carcinoma (HCC), they have not been fully evaluated as feasible for salvage liver transplantation (SLT) of recurrent HCC after hepatic resection. The operative difficulties of SLT increase the operative risk. The aim of this study was to evaluate the feasibility of the Milan criteria for SLT and its operative complications.
  
  
  METHODS
  From March 2005 to November 2007, 46 HCC patients received OLT including 15 SLTs after prior partial hepatectomy (SLT group) and 31 primary OLTs (PLT group).
  
  
  RESULTS
  There was no postsurgical hospital mortality among the SLT group but one case in the PLT group due to pneumonia followed by sepsis. There was no difference in the incidence of surgical complications between the two groups. Overall survival rates of SLT group patients were similar to those of the PLT group (P = .14), especially comparing both groups of patients within the Milan criteria (P = .89). There was no recurrence of HCC among the patients within the Milan criteria.
  
  
  CONCLUSIONS
  SLT is a feasible procedure for recurrent HCC meeting the Milan criteria; the operative risk of the SLT is also acceptable.
authors.affiliation: Department of Surgery, Ajou University School of Medicine, Suwon, South Korea.
authors.forename: B-W
authors.initials: BW
authors.lastname: Kim
authors.forename: Y-K
authors.initials: YK
authors.lastname: Park
authors.forename: Y-B
authors.initials: YB
authors.lastname: Kim
authors.forename: H-J
authors.initials: HJ
authors.lastname: Wang
authors.forename: M-W
authors.initials: MW
authors.lastname: Kim
mesh_terms: D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D018579:Patient Selection; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D016879:Salvage Therapy / Q000379:methods