Hepatocellular carcinoma (HCC) is a growing indication for liver transplantation (LT). Careful candidate selection is a prerequisite to keep post-LT recurrence rates within acceptable percentages. In the pre-LT period, various types of locoregional treatments and/or systemic therapies can be used for bridging or downstaging purposes. In this context, one of the factors limiting the possibility of treatment is the degree of functional liver impairment. In the LT subject, no widely accepted indications are available to guide treatment of disease recurrence and heterogeneity exists between transplant centers. Improved liver function post LT makes multiple therapeutic strategies theoretically feasible, but patient management is complicated by the need to adjust immunosuppressive therapy and to assess potential toxicities and drug–drug interactions. Finally, there is controversy and uncertainty about the use of recently introduced immunotherapeutic drugs, mainly due to the risk of organ rejection. In this paper, we will review the most recent available literature on the management of post-transplant HCC recurrence, discussing evidence and controversies.
肝细胞癌（HCC）作为肝移植（LT）适应症的比例正逐渐增加。严格的受者筛选是确保肝移植后肿瘤复发率维持在可接受范围内的先决条件。在肝移植前阶段，可采用多种类型的局部治疗和/或全身治疗以达到桥接或降期目的。在此背景下，限制治疗可行性的因素之一是肝功能受损程度。对于肝移植受者，目前尚无广泛接受的指导疾病复发治疗的适应症，且各移植中心之间存在治疗方案的异质性。肝移植后肝功能改善理论上使多种治疗策略成为可能，但患者管理因需调整免疫抑制方案、评估潜在毒性及药物相互作用而变得复杂。最后，关于近期引入的免疫治疗药物的使用仍存在争议与不确定性，主要源于其可能引发器官排斥的风险。本文将综述目前关于肝移植后HCC复发管理的最新文献，探讨相关证据与争议。
肿瘤(癌症)患者之家