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

Purpose: Evaluate the recurrence pattern of hepatocellular carcinoma (HCC) following liver transplantation. Materials and Methods: A 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 were analyzed. Results: Seven 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. Conclusion: A significant proportion of HCC recurrence following liver transplantation is extrahepatic