Liver transplantation for hepatocellular carcinoma: Management after the transplant

Elizabeth C. Verna, Yuval A. Patel, Avin Aggarwal, Archita P. Desai, Catherine Frenette, Anjana A. Pillai, Reena Salgia, Anil Seetharam, Pratima Sharma, Courtney Sherman, Georgios Tsoulfas, Francis Y. Yao

Research output: Contribution to journalReview articlepeer-review

81 Scopus citations


Hepatocellular carcinoma (HCC) is an increasingly common indication for liver transplantation (LT) in the United States and in many parts of the world. In the last decade, significant work has been done to better understand how to risk stratify LT candidates for recurrence of HCC following transplant using a combination of biomarker and imaging findings. However, despite the high frequency of HCC in the LT population, guidance regarding posttransplant management is lacking. In particular, there is no current evidence to support specific post-LT surveillance strategies, leading to significant heterogeneity in practices. In addition, there are no current recommendations regarding recurrence prevention, including immunosuppression regimen or secondary prevention with adjuvant chemotherapy. Finally, guidance on treatment of disease recurrence is also lacking and there is significant controversy about the use of immunotherapy in transplant recipients due to the risk of rejection. Thus, outcomes for patients with recurrence are poor. This paper therefore provides a comprehensive review of the current literature on post-LT management of patients with HCC and identifies gaps in our current knowledge that are in urgent need of further investigation.

Original languageEnglish (US)
Pages (from-to)333-347
Number of pages15
JournalAmerican Journal of Transplantation
Issue number2
StatePublished - Feb 1 2020


  • cancer
  • clinical research
  • hepatology
  • liver disease: malignant
  • liver transplantation
  • malignancy
  • neoplasia
  • practice

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)


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