EXPERIENCE OF LIVER TRANSPLANTATION IN CASE OF HEPATOCELLULAR CARCINOMA

Hepatocellular carcinoma is the most common type of malignant liver tumor. The article presents the experience of liver transplantation at the National Scientific Center of Surgery named after A.N. Syzganov in patients with hepatocellular carcinoma. Present study aimed to analyze the results of liver transplantation in patients diagnosed with hepatocellular carcinoma, as well as to determine the effectiveness of liver transplantation in this pathology. A retrospective and prospective study for the period from 2011 to 2017 includes 100 patients with chronic liver disease who underwent liver transplantation on the basis of the department of hepatobiliary surgery and liver transplantation. From this, 86 cases of liver transplantation were carried out from a live donor, while 14 patients performed liver transplantation from a post-mortem donor. In 7 cases, patients were diagnosed with hepatocellular carcinoma, in 3 cases the morphological verification of the diagnosis of hepatocellular carcinoma was determined after transplantation. The mean value of alpha fetoprotein was 657.05 (2.35-3465) ng/ml, from which it was higher than normal only in 3 patients, and in 4 patients it was in normal limits. Hepatitis B virus + hepatitis D virus is diagnosed in 3 cases, positive hepatitis C virus is detected in 3 recipients, whereas in 1 case - hepatitis B virus. The average tumor size was 3.01 (1.0-5.5) cm. Transarterial chemoembolization was performed in two patients before the operation. In 2 cases, taking into account the high alpha fetoprotein values >= 1000 and 3465 ng/ml, a bypass system was used in performing hepatectomy. The histological material after transplantation corresponded to hepatocellular carcinoma, with predominance of the trabecular type of hepatocellular carcinoma. The lethal outcome was in one case due to a vascular complication in the early postoperative period. Despite the small number of patients, the results obtained by us testify to the high efficiency of liver transplantation in patients with hepatocellular carcinoma.