title: Long-term results of incidental hepatocellular carcinoma after liver transplant.
abstract: OBJECTIVE
  The incidence of detecting hepatocellular carcinoma in a removed recipient liver after a liver transplant is not rare. Here, we sought to evaluate incidental hepatocellular carcinoma at our center.
  
  
  METHODS
  Among 296 patients who had undergone a liver transplant between September 2001 and November 2010, we retrospectively analyzed the outcomes of 6 patients with incidental hepatocellular carcinoma. The proportion of incidental hepatocellular carcinoma was 2%. The rate of incidental hepatocellular carcinoma among all hepatocellular carcinoma patients is 11.5%. There were 3 children and 3 adults (mean age, 28.3 ± 26 years; age range, 1-57 years). Two of the 6 patients were 1 year old. Alpha-fetoprotein levels were mildly elevated in 3 patients.
  
  
  RESULTS
  The results of preoperative imaging studies in all patients were normal, except for those that demonstrated regenerative or dysplastic nodules. One of the grafts was from a deceased donor, the remaining 5 were from living-related donors. We encountered no complications after the transplants. Pathology findings showed a mean tumor size of 0.8 ± 0.3 cm (range, 0.5-1.2 cm) and multiplicity in 1 patient. One patient with multiple tumors had microvascular invasion. According to the Tumor Node Metastasis staging system, 5 patients had Stage I, and the remaining patient had Stage II carcinoma. There were no recurrences of hepatocellular carcinoma, and no deaths occurred during a mean follow-up of 63 ± 16.5 months (range, 33-79 months).
  
  
  CONCLUSIONS
  The incidence of hepatocellular carcinoma in patients with cirrhosis who have undergone a liver transplant at our hospital is similar to those reported in other studies. Incidentally found hepatocellular carcinomas showed less-invasive pathologic features and better prognoses than did preoperatively found hepatocellular carcinomas.
authors.affiliation: Department of General Surgery, Baskent University Faculty of Medicine, Ankara, Turkey.
authors.forename: Sema
authors.initials: S
authors.lastname: Aktas
authors.forename: Hamdi
authors.initials: H
authors.lastname: Karakayali
authors.forename: Gokhan
authors.initials: G
authors.lastname: Moray
authors.forename: Nihan
authors.initials: N
authors.lastname: Haberal
authors.forename: Banu
authors.initials: B
authors.lastname: Bilezikci
authors.forename: Mehmet
authors.initials: M
authors.lastname: Haberal
mesh_terms: D000293:Adolescent; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D018572:Disease-Free Survival; D006801:Humans; D015994:Incidence; D007223:Infant; D008103:Liver Cirrhosis / Q000601:surgery*; D008113:Liver Neoplasms / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology