Recurrence of hepatocellular carcinoma after living donor liver transplantation (single center experience)

Abstract

D Liver Transplantation (DLT) started in 1995, using a donor liver with familial amyloid polyneuropathy (FAP), then increasing the pool of donors. Our Center started DLT in 2001; however cases of acquired amyloid neuropathy are increasingly being recognized following this procedure. Also our Center experience showed that the onset of FAP symptoms occurs earlier than expected. Several papers described clinical cases of acquired FAP developing 5 to 9 years after DLT. From 2001 to 2011 we have done 1078 liver transplants; we carried out 262 domino transplantations. All receptors transplanted between 2001 and 2011, were evaluated. All of them were observed and had clinical, histopathologic (salivary gland biopsy) and electrophysiologic evaluation. The symptomatic group started with sensory complaints involving their feet 4 to 10 years after DLT; three of those patients have been retransplanted to halt FAP progression and their clinical and paraclinical improvement is described. Five other patients are in the waiting list for retransplant. Patients with FAP acquired by transplantation are candidates for liver retransplantation to minimize the progression of symptoms. Liver retransplantation is considered to be a high-risk procedure but so far the results have been favorable.