Background
Long-term survival of patients with hepatocellular carcinoma (HCC) after liver transplantation is affected mainly by recurrence of HCC. There is the opinion that the chance of recurrence after 2Β years post-transplantation is remote, and therefore lifelong surveillance is not justified because of limited resources. The aims of the present study were to determine the rate of late HCC recurrence (β₯2Β years after transplantation) and to compare the long-term patient survival outcomes between cases of early recurrence (<2Β years after transplantation) and late recurrence.
Patients
A total of 139 adult HCC patients having liver transplantation during the period from July 1994 to December 2007 were included in the analysis. The median follow-up period was 55Β months. Thirty-two patients received deceased-donor grafts and 107 received living-donor grafts.
Results
Hepatocellular carcinoma recurrence occurred in 24 (17.3%) patients, among them 22 (86%) had living-donor grafts and 7 (5%) developed late recurrence. Patients in the early recurrence group and patients in the late recurrence group had comparable demographics and disease pathology. The former group, when compared with the latter, had significantly worse overall survival at 3Β years (13.3 versus 100%) and 5Β years (6.67 versus 71.4%) (log-rank test; pΒ <Β 0.001).
Conclusions
Both early recurrence and late recurrence of HCC after liver transplantation were not uncommon, mostly detected at a subclinical stage. Regular and long-term surveillance with imaging and blood tests is essential for early detection.