Objective: To compare the prognosis of patients underwent primary liver transplantation and salvage liver transplantation within Hangzhou criteria, and to evaluate the efficacy of salvage liver transplantation.
Methods: The clinical data of 272 liver cancer patients, who underwent DCD liver transplantation at Huashan Hospital affiliated to Fudan University from May 2014 to October 2019, were retrospectively analyzed. 205 of these patients met the Hangzhou criteria before surgery, including 147 cases were performed primary liver transplantation (PLT) and 58 cases were preformed salvage liver transplantation (SLT). The chi-square test was adopted to compare the postoperative complications and perioperative deaths. Kaplan-Meier curve was plotted according to the follow-up results. In addition, log-rank test was implemented to compare the overall survival rate, as well as the disease-free survival rate between the two groups of subjects.
Results: There were no significant differences in postoperative rejection, biliary complications, vascular complications, and perioperative death between the SLT group and the PLT group (P>0.05). The incidence of postoperative infection in the SLT group was higher than that in the PLT group ( P <0.05). The overall survival rates at 1, 3, and 5 years after surgery in the SLT group were 89.3%, 74.1%, and 74.1% respectively; while those in the PLT group were 83.6%, 80.7%, and 80.7% respectively (P>0.05). The 1-, 3-, and 5-year disease-free survival rates in the SLT group were 80.3%, 64.2%, and 64.2%; and such rates in the PLT group were 91.1%, 84.3%, and 73.8% respectively (P>0.05).
Conclusion: For patients with recurrent liver cancer after hepatectomy that meets the Hangzhou criteria, salvage liver transplantation is a feasible strategy. Patients with salvage liver transplantation need to pay more attention to prevention and the control of postoperative infection.