| [ Summary ] |
With the introduction of transplantation into the field of adult liver disease treatment, many patients with hepatocellular carcinoma have had liver transplantats. Recently, however, the indications for transplantation have been restricted in many countries, because of high recurrence rates after liver transplantation. In our hospital, 49 living donor liver transplantats for hepatocellular carcinoma have been performed without any limitations as to tumor size or number. We do not accept patients with large intrahepatic vascular invasion or extrahepatic spreading. According to the International Union against Cancer (UICC) classification, 4 had stage I, 8 stage II, 4 stage III and 33 stage IV. Six patients have had recurrences. One-year and 3-year patient survival rates are 74.1%, 54.3%, respectively. One-year and 3-year recurrence rates are 15.5%, 36.6%, respectively. Intrahepatic vascular invasion, large tumor size and histopathologic results are risk factors for recurrence. Patients who met the "Milan criteria" have had no recurrences. These patients are considered to be good candidates. Although even patients in the more advanced stages can become candidates for liver transplantation, informed consent is necessary because of the high recurrence rates. |