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Prajapati et al. Hepatoma Res 2017;3:182-8 Hepatoma Research
DOI: 10.20517/2394-5079.2017.25
www.hrjournal.net
Original Article Open Access

Transcatheter arterial chemoembolization

in recurrent unresectable hepatocellular

carcinoma after orthotopic liver

transplantation

Hasmukh J. Prajapati , Pavan Kavali , Hyun S. Kim
1
3,4
2
1 Division of Interventional Radiology, Department of Pediatric Radiology, The University of Tennessee Health Science Center, Memphis, TN 38103, USA.
2 Division of Interventional Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA.
3 Division of Interventional Radiology, Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT 06510, USA.
4 Yale Cancer Center, Yale School of Medicine, New Haven, CT 06510, USA.
Correspondence to: Dr. Hyun S. Kim, Yale Cancer Center, Yale School of Medicine, 330 Cedar Street, TE 2-224, New Haven, CT 06510, USA.
E-mail: kevin.kim@yale.edu

How to cite this article: Prajapati HJ, Kavali P, Kim HS. Transcatheter arterial chemoembolization in recurrent unresectable hepatocellular carcinoma
after orthotopic liver transplantation. Hepatoma Res 2017;3:182-8.
ABSTRACT

Article history: Aim: To investigate the survivals and efficacy of the doxorubicin drug eluting beads
Received: 19-06-2017 transcatheter arterial chemoembolization (TACE) in patients with recurrent hepatocellular
Accepted: 03-08-2017 carcinoma (HCC) status post orthotopic liver transplantation. Methods: Consecutive
Published: 17-08-2017 patients with HCC who underwent orthotopic liver transplantation from 2005 to 2012 were
reviewed. Patients who developed recurrent HCC after orthotopic liver transplantation and
Key words: received doxorubicin drug eluting beads TACE therapy were identified and included in the
Doxorubicin drug eluting study. Survivals were calculated from the time of 1st doxorubicin drug eluting beads TACE
beads transcatheter arterial of recurrent HCC. Kaplan Meier estimator with log rank test was used for survival analysis.
chemoembolization, Results: Eight patients had recurrent HCC after orthotopic liver transplantation and received
recurrent hepatocellular doxorubicin drug eluting beads TACE. The overall median survival of these patients was 15.6
carcinoma, months. Two patients had significantly poorer overall median survival from doxorubicin drug
orthotopic liver transplantation, eluting beads TACE (3.4 months) and both showed elevated serum alpha-fetoprotein levels
sorafenib, (> 400 ng/mL) and extra-hepatic metastases (P = 0.03). Patients with poorly differentiated
alpha-fetoprotein HCC in explant liver had the poor median overall survival (3.6 months) compared to the
patients with well-to-moderately differentiated HCC (21.7 months, P = 0.004). Conclusion:
Doxorubicin drug eluting beads TACE appears to be an effective treatment option for patients
with recurrent HCC after orthotopic liver transplantation.

INTRODUCTION treatment options for HCC and cirrhosis, orthotopic
liver transplantation (OLT) is considered the curative
Hepatocellular carcinoma (HCC) is one of the leading treatment option, especially for patients with end-
cause of cancer related death globally. Among all the stage liver disease. Unfortunately, recurrence of HCC
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