Tumor Recurrence Of Hepatocelluar Carcinoma After Liver Transplantation And The Improving Of Donor Harvesting Technique

Objective: To determine the clinical factors and AFPmRNA affecting tumor recurrence and patient survival of hepatocellular carcinoma (HCC) following orthotopic liver transplantation (OLT), and improve the techique of the donor harvesting. Methods: Clinical and laboratory data, tumor size, number and distribution and vascular invasion were analyzed in 31HCC with OLT. Real time quantality RT-PCR was used to detection AFPmRNA in peripheral blood. Improved the technique of combined Liver and kidney harvesting by perfusion the liver from the superior mesentery vein (SMV). Results: Univariate analysis showed that the following variables correlated significantly with tumor recurrence: tumor size, vascular invasion, pTNM, Milan-criteria. Child-Pugh grade, Edmondson Grade and tumor number were no significantly with tumor recurrence. Vascular invation and pTNM were risk factors for long-term survival. No primary disfunction was found in all the graft. Conclusion: It is suggested that tumor size, pTNM, vascular invasion and MILAN-criteria were risk factor of tumor recurrence, and so that affecting the tumor free survival. The level of AFP mRNA in peripheral blood may indicate recurrence and/or metastasis after transplantation of HCC. And may be a independent fator which predict the patient tumor free survival and overall survival. It is suggested that this technique could shorten the warm ischemic time, pledge the quality of harvesting organ and make full use of cadaveric organs.