Prognostic Factors of Recurrence and Survival after Living-donor Liver Transplantation for Hepatocellular Carcinoma: Mansoura Experience

Background: To evaluate our center experience of living-donor liver transplantation (LDLT) in hepatocellular carcinoma (HCC) patients regarding recipients’ mortality and morbidity and study the various prognostic factor affecting tumor recurrence and its impact on patients’ survival. Methods: This is a retrospective study including patients who underwent LDLT for HCC complicating liver cirrhosis in period from 2004 to 2020. Results: The study included 252 patients. The mean age was 52 ± 6 years. All patients had underlying liver cirrhosis with hepatis C virus in 241 patients (95.6%). The mean MELD score was 14 ± 4 and mean alpha-feto protein (-FP) 73 ± 178 ng/ml. 138 patients (54.8%) subjected to preoperative loco-regional therapy. The patients received right hemi-liver graft without the middle Hepatic vein. The mean graft weight was 911 ±181 gm and mean GRWR 1.9 ± 0.3. Morbidity occurred in 86 patients (34.1%). Mortality occurred in 71 patients (28.1%). The mean fallow-up duration ranged from 6 – 173 months. The 1-, 3-, and 5-year disease-free survival rate was 93%, 85%, and 78%, respectively. Multivariate analysis shows that the only significant factor for tumor recurrence are vascular invasion -FP>200 ng/ml. Conclusion: LDLT solve the problem of organ shortage and dropout of the list, however, recurrence of the tumors, still a major problem affecting recipients’ survival.