Risk factors attributing to fatal recurrence in liver transplant recipients with hepatocellular carcinoma died within one year

Abstract

Objective To investigate the clinicopathological risk factors for fatal recurrence of hepatocellular carcinoma(HCC)in orthotopic liver transplant(OLT)recipients died within one year.Methods The clinical data of 303 patients receiving OLT in our hospital from April 2002 tO April 2005 were retrospectively analyzed.Forty-eight of these patients who demonstrated diffuse intra-he-patio or multiple systemic recurrent lesions and died within 1 year after surgery were furthere investi-gated.The remaining patients were designated as the control group.The 2 groups were compared for clinicopathologic risk factors by logistic regression analysis. Results Among the 303 patients,48 were enrolled in the ratal recurrence group(15.84%).Multivariate analysis showed that presence of vascular invasion,tumor size greater than 6.5 cm,and pre-operative serum alpha-fetoprotein(AFP) level greater than 1000 μg/L were the risk factors in the fatal recurrence group.A percentage of 85.71%of the patients who had all the three risk factors.37.84% of those who had two risk factors,13.64%of those who had one risk factors,and 6.71%of those who had none risk factors died be-cause of recurrence within 1 year after transplantation.Conclusion Three distinct risk factors attribu-ting to fatal recurrence of liver transplant recipients for HCC are vascular invasion,tumor size ≥6.5 cm,and pre-operative serum AFP level≥1000 μg/L.The high risk HcC patients with two or more risk factors should not be the candidates for liver transDlantation. Key words: Liver transplantation; Hepatocellular carcinoma; Recurrence; Mortafity