Liver transplantation for hepatocellular carcinoma.

This is the authors' abstract. We don't add key points for this paper.

Liver transplantation for hepatocellular carcinoma As experience in orthotopic liver transplantation (OLT) has accumulated, it has become clear that frequent tumour recurrence has impaired overall survival figures for patients transplanted for hepatocellular carcinoma (HCC). In most series, two year survival has been 30% or lessl-5 and in the context of a limited supply of donor organs, the validity of continuing to transplant such cases has been called into question.3 6 Some HCC patients do achieve a cure with OLT, in particular those in whom the tumour is an incidental one, being found only on examination of the explant.46 These lesions are usually small, and tumour recurrence is less common -between O0/o-1 3% compared with 370/o-82% in cases where the diagnosis of HCC was established before operation.3 5 7 8 In general, the smaller the tumour the less likely it is to recur, but in a few patients even with large tumours cure is obtained, as in an early case in the Cambridge/King's College Hospital series when the tumour weighed 4 kg.9 Cases such as this add to the difficulty of decision making for the physician and patient who may feel that even the smallest chance of a cure is worth taking.