Hepatocellular carcinoma recurrence pattern following liver transplantation and a suggested surveillance algorithm

PurposeThis study aims to evaluate the recurrence pattern of hepatocellular carcinoma (HCC) following liver transplantation.Materials and methodsA total of 54 patients underwent liver transplantation for HCC; 9 patients developed biopsy-proven recurrent HCC (16.6%). The site of HCC recurrence along with other factors was analyzed.ResultsSeven patients were diagnosed with HCC prior to liver transplantation and 2 patients had incidental HCC in the explanted liver. Two patients had locoregional recurrence, 4 patients had distant metastasis, and 3 patients had synchronous locoregional recurrence and distant metastasis.ConclusionA significant proportion of HCC recurrence following liver transplantation is extrahepatic.