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World J Hepatol. Mar 27, 2019; 11(3): 261-272
Published online Mar 27, 2019. doi: 10.4254/wjh.v11.i3.261
Hepatocellular carcinoma recurrence after liver transplantation: Risk factors, screening and clinical presentation
Norma Arteiro Filgueira
Norma Arteiro Filgueira, Department of Internal Medicine, Universidade Federal de Pernambuco, Recife, Pernambuco 50670-901, Brazil
Author contributions: Filgueira NA contribuate to conception and design, literature review and writing of article.
Conflict-of-interest statement: No potential conflicts of interest, no financial support
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Norma A Filgueira, MD, PhD, Professor, Department of Internal Medicine, Universidade Federal de Pernambuco, Av. Prof. Moraes Rego, 1235, Cidade Universitária, Recife, Pernambuco 50670-901, Brazil. norma.arteiro@hotmail.com
Telephone: +55-81-9991416308
Received: February 6, 2019
Peer-review started: February 6, 2019
First decision: March 5, 2019
Revised: March 6, 2019
Accepted: March 16, 2019
Article in press: March 16, 2019
Published online: March 27, 2019
Processing time: 50 Days and 8.1 Hours
Core Tip

Core tip: Recurrence of hepatocellular carcinoma (HCC) after liver transplantation usually portends a poor prognosis with short survival. Besides well recognized risk factors for post-transplant HCC recurrence, as tumor staging and vascular invasion, this review discusses other factors strongly associated with the recurrence risk, such as alpha-fetoprotein levels, tumor uptake of FDG in Pet scan, response to locoregional therapy and post-transplant immunosuppression. We present proposals of a screening protocol for tumor recurrence after transplantation and of criteria to identify patients with good prognosis after recurrence, who might benefit from aggressive antitumor therapy.