LAUSR

Background: The best outcome for the treatment of hepatocellular carcinoma (HCC) is liver transplantation (LT). But due to the donor shortage or a risk of tumor recurrence, salvage liver transplantation (SLT) may be used as an alternative to primary liver transplantation (PLT). Patients and Methods: From January 2001 to December 2018, 1069 liver transplantation performed at our institution. 430 adult patients underwent LT to treat HCC, and 53 of them had SLT. To compare and analyze PLT and SLT, we evaluated postoperative mortality, tumor recurrence, disease-free survival (DFS) and overall survival (OS). Results: The mean age of PLT group was 53.5 and the mean age of SLT group was 53.2. The average interval to SLT after resection was 28.7 months. Postoperative mortality was 14 (3.7%) in the PLT group and 2 (3.8%) in the SLT group (p=0.98). Tumor recurrence occurred in 81 (21.5%) patients with PLT and 17 (32.1%) patients with SLT (p=0.09). The PLT and SLT groups significantly differed in terms of DFS, and OS rates. The 5-year DFS and OS in the PLT group were 78.4% and 72.1%, better than 60.9% and 59.1% of the SLT. However, in the SLT group, the 5-year survival rate from resection with intention to treat was 73.1%, which was not different from the PLT group. Conclusions: Surgical technique and postoperative care development make SLT as safe as PLT. However, if the donor is ready when transplantation is needed, such as living donor liver transplantation, there is no need for SLT. P-12.69