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Background: Liver transplantation is now one of established therapeutic options for patients with hepatocellular carcinoma (HCC). The aim of study is to describe the current practice of living donor liver transplantation (LDLT) for HCC, including the patient selection criteria, surgical techniques, management of small-for-size syndrome, postoperative complications, and the results of our center. Methods: We prospectively analyzed the data on all right lobe LT adult patients for HCC, consecutively performed from October 2017 to June 2022 in Military Central Hospital 108. Our center practices careful selection for HCC patients using the Milan and University of California San Francisco (UCSF) criteria, supplemented by alpha-fetoprotein level and the model for end-stage liver disease (MELD) score. We pioneered in using the extended right lobe graft and the novel hepatic venoplasty technique, which lessen the risk of hyperperfusion and small-for-size syndrome with improved overall recipient survival. When the remnant and total liver volume ratio less than 35%, we used modified right lobe graft. We conjoined the middle hepatic vein and right hepatic vein as a single orifice hepatic vein. Data were collected prospectively and presented as the mean values and ranges, or the number of patients in proportion of total patient population. Results: A total of 57 cases of adult-to-adult LDLT using right lobe graft for HCC treatment were collected. Of our patients, and 50,8% met the Milan and UCSF criteria. Regarding the Milan and UCSF criteria, the 2-year recurrence rate was significantly lower in patients who met Milan than in patients who exceeded the Milan criteria (1.75% vs. 14%). A 5-year overall and disease-free survival rate of 73.5% and 70.3% were achieved. Seventy-three point six percent of the complications were rated as Clavien I. Conclusions: LDLT is an ideal treatment for HCC in Vietnam with regard to the critical organ shortage and high demand for transplantation.

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NT, Bang MH. Combined transarterial chemoembolization and stereotactic body radiation therapy as a bridge therapy to liver transplant for hepatocellular carcinoma.