title: Liver transplantation in patients with hepatocellular carcinoma: a single-center experience.
abstract: OBJECTIVE
  Liver transplantation has become one of the best treatment options for early hepatocellular carcinoma in cirrhosis. We sought to study the results of liver transplantation in patients with hepatocellular carcinoma and to evaluate the outcome of the patients.
  
  
  METHODS
  The medical records of 256 recipients who underwent a liver transplantation from April 2001 to January 2010 were reviewed. One hundred seventy-six patients received their livers from deceased donors, and 80 received their livers from living donors. Fifty-two patients underwent liver transplantation for hepatocellular carcinoma.
  
  
  RESULTS
  From April 2001 until now, 52 patients (20.3%) underwent liver transplantation for hepatocellular carcinoma. Eighteen patients (34.6%) were performed from living-related donors, and 34 (65.4%) were from deceased donors. The patients were 37 males and 15 females (median, 55 years old; age range, 5 through 68 years). Model for end-stage liver disease score ranged from 6 to 40 with a median of 14. All patients were within the Milan criteria by the preoperative evaluation. Hospital stay ranged from 6 to 338 days with a median 14 days. Operating time ranged from 4 to 15 hours with a median 7.5 hours. Blood transfusion ranged from 0 to 19 units median 5 units. Thirty-four complications occurred in 23 patients (44.2%). Recurrence of hepatocellular carcinoma in 7 patients (13.5%), of which recurrent cholangiocarcinoma was diagnosed in 3 (5.7%), accidentally discovered in the explant. One deceased donor had hepatitis B core antibody positive. One explant showed macrovascular invasion. Sixteen patients died, 7 of 52 (13.5%) from hepatocellular carcinoma recurrence, including the 3 cases of accidental discovery of cholangiocarcinoma (5.7%).
  
  
  CONCLUSIONS
  Apart from the common complications that can occur with any transplantation, liver transplantation remains the most-promising solution for patients with hepatocellular carcinoma among the available ones, and represents a cornerstone in managing hepatocellular carcinoma. It is the only acceptable option for complete eradication of both the disease and the predisposing factor.
authors.affiliation: Liver Transplantation and Hepatobiliary-Pancreatic Surgery Department, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia. aazzam70@yahoo.com
authors.forename: Ayman Zaki
authors.initials: AZ
authors.lastname: Azzam
authors.forename: Bassem
authors.initials: B
authors.lastname: Hegab
authors.forename: Hatem
authors.initials: H
authors.lastname: Khalaf
authors.forename: Hamad
authors.initials: H
authors.lastname: Al Bahili
authors.forename: Hazem
authors.initials: H
authors.lastname: Mohammed
authors.forename: Yasser
authors.initials: Y
authors.lastname: Kamel
authors.forename: Faisal
authors.initials: F
authors.lastname: Abaalkhail
authors.forename: Faisal
authors.initials: F
authors.lastname: Abal Khail
authors.forename: Waleed
authors.initials: W
authors.lastname: Al-hamoudi
authors.forename: Mohammad
authors.initials: M
authors.lastname: Al Sofayan
authors.forename: Mohammed
authors.initials: M
authors.lastname: Al Sebayel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001803:Blood Transfusion; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects / Q000401:mortality; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012529:Saudi Arabia; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult