Majority of Hepatocellular carcinomas in Turkey accompanied with HBV or HCV related cirrhosis and many of them are irresectible at the time of diagnosis.
Liver transplantation seems to only curative treatment option for these patients who have cirrhosis and irresectible hepatocellular carcinoma without extra hepatic dissemination.
In this study, we evaluate the early results of living related liver transplantation for irresectible hepatocellular carcinoma.
Between 2003 and 2004, seven patients aged 1.1 to 64 years, with HCC (three occult, four incidental) underwent liver transplantation in our unit.
Our extanded criteria of liver transplantation for HCC were:
1. No evidence of extra hepatic dissemination with advanced imaging studies,
2. No major vascular invasion,
3. Negative cytopathology of intraperitoneal fluid and
4. Negative surgical exploration including hyler lymph node frozen section.
All patients received tacrolimus monotherapy with low dose early withdrawal corticosteroid.
In 1-10 months of follow up period, all patients doing well with excellent graft function. There is no evidence of tumor recurrence with imaging studies and tumor markers including µFP and CEA.
Two patients had neodajuvant chemoembolization with farmarubicine, cysplatin, mitomicyn-C and polyvinyl alcohol. There is no patient who received adjuvant chemotherapy. Two patients with HBV cirrhosis underwent prophylaxis with six doses of anti HBs antibody (Hepatect “, Biotest) and lamivudine. We kept anti HBs antibody level more than 100 IU with monthly antibody infusion in those patients.
The tacrolimus monotherapy and extanded criteria of liver transplanttaion for HCC appears to have beneficial effects on recurrence disease and patient outcome, epecially in living donation era.