[The mechanism and current strategies for preventing the recurrence of hepatocellular carcinoma after liver transplantation].

ABSTRACT

The recurrence rate of hepatocellular carcinoma (HCC) after liver transplantation is still high, seriously affecting the long-term survival rate. The current research results show that the mechanism of postoperative recurrence of liver cancer is mainly related to residual micro-lesions, hepatitis, regeneration and immunosuppression. Milan criteria for liver transplantation, tumor vascular invasion, degree of differentiation, surgical procedures, and the use of calcineurin immunosuppressive agents are risk factors for recurrence of HCC after liver transplantation, and biomarkers such as genes and miRNAs that respond to biological characteristics of the tumor have been gradually used in HCC recurrence risk stratification and predicting prognosis. The use of mTOR inhibitors, preoperative interventional treatment before liver transplantation and non -tumor ablation technique are the main effective methods to prevent the recurrence of HCC. Hepatectomy is still the most effective treatment for patients with recurrent HCC after transplantation, and intervention with sorafenib in combination with mTOR inhibitors can benefit the survival of most patients.