Why were survival rates low for hepatocellular carcinoma (HCC) following liver transplantation in the 1990s?

Updated: Jan 31, 2021
  • Author: Luca Cicalese, MD, FACS; Chief Editor: John Geibel, MD, MSc, DSc, AGAF  more...
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Answer

The initial experience with liver transplantation for patients with HCC was unrewarding with high rates of recurrence in the allograft (transplanted liver) and extrahepatically. [80] Reports from the national transplant tumor registry in 1991 revealed a 5-year survival rate of only 18%. [81] In the survivors, only 9% remained tumor-free at 2 years.

These dismal survival data led to a moratorium on transplantation for HCC in the early 1990s. However, further investigations suggested that these results were likely the result of poor patient selection and transplantation in the face of extensive tumor burden. In patients with incidentally discovered small tumors, the results were actually quite good, leading to the subsequent reassessment of HCC as an indication for OLT.


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