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Journal of Transplantation
Volume 2017 (2017), Article ID 9731095, 9 pages
https://doi.org/10.1155/2017/9731095
Research Article

Blood Transfusions and Tumor Biopsy May Increase HCC Recurrence Rates after Liver Transplantation

1Department of General, Visceral and Transplantation Surgery, Charité Campus Virchow, Berlin, Germany
2Department of Radiology, Charité Campus Virchow, Berlin, Germany
3Department of Gastroenterology and Hepatology, Charité Campus Virchow, Berlin, Germany

Correspondence should be addressed to Daniel Seehofer; ed.gizpiel-inu.nizidem@refohees.leinad

Received 10 July 2016; Accepted 7 November 2016; Published 5 January 2017

Academic Editor: Yuri Genyk

Copyright © 2017 Daniel Seehofer et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. Beneath tumor grading and vascular invasion, nontumor related risk factors for HCC recurrence after liver transplantation (LT) have been postulated. Potential factors were analyzed in a large single center experience. Material and Methods. This retrospective analysis included 336 consecutive patients transplanted for HCC. The following factors were analyzed stratified for vascular invasion: immunosuppression, rejection therapy, underlying liver disease, age, gender, blood transfusions, tumor biopsy, caval replacement, waiting time, Child Pugh status, and postoperative complications. Variables with a potential prognostic impact were included in a multivariate analysis. Results. The 5- and 10-year patient survival rates were 70 and 54%. The overall 5-year recurrence rate was 48% with vascular invasion compared to 10% without (). Univariate analysis stratified for vascular invasion revealed age over 60, pretransplant tumor biopsy, and the application of blood transfusions as significant risk factors for tumor recurrence. Blood transfusions remained the only significant risk factor in the multivariate analysis. Recurrence occurred earlier and more frequently in correlation with the number of applied transfusions. Conclusion. Tumor related risk factors are most important and can be influenced by patient selection. However, it might be helpful to consider nontumor related risk factors, identified in the present study for further optimization of the perioperative management.