salvage liver transplantation for patients with recurrent hepatocellular carcinoma after curative resection抢救肝移植后复发性肝细胞癌患者治疗切除.pdfVIP

Salvage Liver Transplantation for Patients with Recurrent Hepatocellular Carcinoma after Curative Resection 1. 1. 1. 2 2 1 1 LinWei Wu , AnBin Hu , Ngalei Tam , JianWei Zhang , Min Lin , ZhiYong Guo *, XiaoShun He * 1 Organ Transplant Center of the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China, 2 Zhongshan Medical School of Sun Yat-sen University, Guangzhou, China Abstract Objective: To summarize the experience with salvage liver transplantation (SLT) for patients with recurrent hepatocellular carcinoma (HCC) after primary hepatic resection in a single center. Methods: A total of 376 adult patients with HCC underwent orthotopic liver transplantation (OLT) at Organ Transplantation Center, the First Affiliated Hospital of Sun Yat-sen University, between 2004 and 2008. Among these patients, 36 underwent SLT after primary liver curative resection due to intrahepatic recurrence. During the same period, one hundred and forty- seven patients with HCC within Milan criteria underwent primary OLT (PLTW group), the intra-operative and post-operative parameters were compared between these two groups. Furthermore, we compared tumor recurrence and patient survival of patients with SLT to 156 patients with HCC beyond Milan criteria (PLTB group). Cox Hazard regression was made to identify the risk factors for tumor recurrence. Results: The median interval between initial liver resection and SLT was 35 months (1–63 months). The intraoperative blood loss (P,0.05) and transfusion volume (P,0.05) were larger in the SLT group than in the PLTW group. The operation time was longer in the SLT group (P,0.05). The post-operative complications incidence, tumor recurrence rate, patients’ survival