肝癌切除术后复发的补救性肝移植

目的 评估肝癌患者肝癌切除术后肝癌复发行补救性肝移植术的临床治疗效果及预后影响因素.方法 回顾性分析本治疗组自2000年4月至2008年6月间实施的88例肝癌切除术后复发行补救性肝移植术病例,分析该组病例手术特征、生存状况、病理因素对预后影响.结果 肝癌切除术后复发行补救性肝移植病例平均年龄为52.4±9.2岁(26....

SLAVAGE LIVER TRANSPLANTATION FOR HEPATOCELLULAR CARCINOMA RECURRENCE AFTER LIVER RESECTION

Objective To evaluate the clinical efficacy and factors that might effect the prognosis of salvage liver transplantation（SLT） for hepatocellular carcinoma（HCC） recurrence after liver resection.Methods From April 2000to June 2008,88 patients underwent SLT for HCC recurrence after resection.Statistically analysis the operative characteristics,survival,and the effect of pathologic features to prognosis of salvage liver transplantation.Results The mean age of the patients underwent SLT was 52.4±9.2 years old（range 26.8～74.3）with a median follow up of 39.2 months,mean operating time was 10.76±3.05 hours,mean blood loss was 3254.6±2809.3 ml;the post transplant 0.5-,1-,3-,and 5-year overall survival rates for salvage liver transplantation were 85.0%,70.8%,51.3%,44.7%;17 patients with HCC recurrence were within Milan Criteria underwent SLT,70 patients were beyond Milan Criteria,however,but there was no significant statistical difference in overall survival rate in the two groups（P（0.295）0.05）;the factors such as Edmondson grade,TNM stage,invasion of hepatic vein and portal vein significantly effect the prognosis of SLT.Conclusions Salvage liver transplantation for HCC recurrence after liver resection does not increase the risk of operations or impair long-term survival following transplant;in the era of organ shortage,SLT is a effective treatment strategy for patients with HCC recurrence after liver resection.