Introduction

Autotransfusion (AT) is rarely used in liver transplantation of hepatocellular carcinoma (HCC) patients due to the fear of disease transmission. Leukocyte depleting filters (LDF) can remove HCC cells from blood. We aim to evaluate the safety of AT with LDF during transplantation in HCC patients.

Methods

A retrospective study of a prospectively obtained database of HCC patients transplanted from 12/2012 – 08/2015, was stratified into 2 groups: an AT Cohort and a Control Group. Surveillance of recurrence was performed using protocol chest CT and abdominal MRI. The groups were compared for HCC recurrence, patient and disease-free survival.

Results

94 HCC patients were included: AT Cohort (n=43) and Control Group (n=51). No differences in recipient and donor demographics were seen except a longer WIT in the AT Group (55min vs 45min, p=0.04). There was no difference in tumor criteria including tumor grade, vascular invasion, pretransplant chemoembolization or patients within Milan and Region 4 criteria. There was similar PRBC use between the AT Cohort and Control Group (5.6 vs 3.6U, p=0.72). There were no recurrences of HCC in the in the AT Cohort and 1 recurrence in the Control Group (p=1.00) (figure 1). The 1-year survival in the AT Cohort vs Control Group was 95% vs 92% (p=0.75) (figure 2).

Conclusions

This study demonstrates the use of AT with LDF in HCC patients with no increase in HCC recurrence after short-term follow up. The authors advocate the use of AT with LDF in liver transplantation for HCC.

CITATION INFORMATION: Gupta A, Ramsay M, Saracino G, Anthony T, Goldstein R, McKenna G, Onaca N, Ruiz R, Klintmalm G, Kim P. Use of Autotransfusion During Liver Transplantation for Hepatocellular Carcinoma Does Not Increase Recurrence. Am J Transplant. 2016;16 (suppl 3).

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