Liver transplantation for hepatocellular carcinoma: Management after the transplant.

Journal Article (Journal Article;Review)

Hepatocellular carcinoma (HCC) is an increasingly common indication for liver transplantation (LT) in the United States and in many parts of the world. In the last decade, significant work has been done to better understand how to risk stratify LT candidates for recurrence of HCC following transplant using a combination of biomarker and imaging findings. However, despite the high frequency of HCC in the LT population, guidance regarding posttransplant management is lacking. In particular, there is no current evidence to support specific post-LT surveillance strategies, leading to significant heterogeneity in practices. In addition, there are no current recommendations regarding recurrence prevention, including immunosuppression regimen or secondary prevention with adjuvant chemotherapy. Finally, guidance on treatment of disease recurrence is also lacking and there is significant controversy about the use of immunotherapy in transplant recipients due to the risk of rejection. Thus, outcomes for patients with recurrence are poor. This paper therefore provides a comprehensive review of the current literature on post-LT management of patients with HCC and identifies gaps in our current knowledge that are in urgent need of further investigation.

Full Text

Duke Authors

Cited Authors

  • Verna, EC; Patel, YA; Aggarwal, A; Desai, AP; Frenette, C; Pillai, AA; Salgia, R; Seetharam, A; Sharma, P; Sherman, C; Tsoulfas, G; Yao, FY

Published Date

  • February 2020

Published In

Volume / Issue

  • 20 / 2

Start / End Page

  • 333 - 347

PubMed ID

  • 31710773

Electronic International Standard Serial Number (EISSN)

  • 1600-6143

Digital Object Identifier (DOI)

  • 10.1111/ajt.15697


  • eng

Conference Location

  • United States