How to treat recurrence of liver cancer after liver transplantation

If liver cancer recurs after liver transplantation, treatment is relatively difficult. Generally speaking, surgical resection, liver transplantation again, local ablation, chemotherapy, hepatic artery embolization chemotherapy, etc. should be used according to the patient's condition. Clinically, different treatment plans are selected according to specific circumstances, generally including the following aspects.

(1) Adjust the dose of immunosuppressants. Generally, cyclosporine or tacrolimus plus mycophenolate mofetil plus hormone triple therapy is used to prevent rejection after liver transplantation. If recurrence occurs, the use of immunosuppressants can be appropriately adjusted. Without increasing the incidence of acute rejection, hormones should be discontinued first, and the dose of cyclosporine should be reduced. Immunosuppressants with tumor suppressive effects, such as sirolimus (rapamycin), can also be added.

(2) Surgical treatment: Reoperation to remove the recurrent tumor is the most effective way to improve the overall survival rate and disease-free survival rate.

(3) Minimally invasive treatment: Isolated or small multiple tumors with a diameter of less than 3 cm can be treated with anhydrous ethanol injection, radiofrequency or other local ablation treatments. For multiple tumors or larger tumors that recur in the liver and cannot be surgically removed or treated with local radiofrequency ablation, hepatic artery chemoembolization can be used.

(4) Other treatments. If the patient has extensive metastasis, palliative treatments such as radiotherapy and chemotherapy can be used to control local tumor growth, improve the patient's quality of life, reduce pain, and prolong life.