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LIVER TRANSPLANTATION – A PARADIGM IN THE SURGICAL TREATMENT OF HEPATOCELLULAR CARCINOMA IN PATIENTS WITH NON-VIRAL LIVER CIRRHOSIS

Keywords: HEPATOCELLULAR CARCINOMA , LIVER TRANSPLANTATION , NONVIRAL CIRRHOSIS

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Abstract:

Worldwide the rate of hepatocellular carcinoma (HCC) is continuing increasing and the survival rate, without treatment, varies between 6 and 20 months. The actual surgical management comprises liver resections, focal ablation and liver transplantation. Apparently the liver transplantation is the best treatment both for liver cirrhosisand HCC. However, the literature data about liver transplantation for HCC associated with nonviral liver cirrhosis (NVLC)are limited.METHODS:We performed an observational study about the patients who underwent orthotopic liver transplantation for HCC arising in NVLC. Different clinical, operative, pathological and follow-up data were recorded into a MS Excel Database and statistically analyzed. RESULTS: We included 12 patients with a mean age of 59.3±2.8 years old(range: 56-64). All the patients were men. According to Child-Pugh score, 16.6% (N=2) were in stage A, 41.7% (N=5) in stage B and the other 41.7% (N=5) in stage C. The mean value for MELD score was 9.8±7.1. The mean operation time was 405±102 min and intraoperative mean blood loss was 1850±1560 mL. The tumors had a mean diameter of 27.5 (range: 10-60). Major postoperative complications were noted in 5 cases. We noted no postoperative deaths. The overall survival rate was 91.67%; one death was noted 8 months after the operation. The mean survival time was 34.9±26.5 months (median: 33). No loco-regional recurrence was noted.CONCLUSIONS: Liver transplantation represents a good choice for HCC associated with NVLC. The long term results are apparently superior to the others surgical procedures, with low rates of recurrence.

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