A liver transplant can be a potential cure for HCC in a selected group of patients who also have cirrhosis; as the whole liver is replaced.
This can be an option for whom surgery might be considered but the severity of their liver disease means that surgery is not an option.
The size and number of tumours needs to be under a certain criteria and the patient must be generally fit enough to withstand a large operation.
Is my tumour suitable?
If the team is considering transplantation then the patient will need to be referred to a liver transplant centre who, if in agreement, will go on to organise an assessment for suitability for transplantation.
This assessment varies slightly from centre to centre; in some centres this is done as an out patient on a single day whereas in some centres the assessment can last several days. The assessment will include investigations to assess the patients liver function and tumour burden along with an assessment of the patients general health including heart and lungs.
What happens next?
If it is felt that a patient is appropriate for transplantation they are placed on the transplant waiting list. The time a patient can wait on the waiting list is very variable, the average length of time awaiting an organ is 99 days in the UK but some patients can wait much longer than this.
Whilst on the waiting list a patient will undergo regular scans and clinic review. In some instances a patient’s cancer can progress whilst on the waiting list or their health can change making them no longer suitable for liver transplantation.
In certain cases it may be possible to offer other treatments such as TAE/TACE or ablation whilst on the waiting list to try and slow progression enabling the patient to remain on the transplant list.
Liver rejection and graft failure
The biggest complication that can occur following a liver transplant is liver rejection and graft failure.
Liver rejection is when the body attacks the new liver and graft failure occurs when the new liver is not working as it should.
Side effects of immunosuppressant medication
Sometimes, side effects can occur from the immunosuppressant medication you take following a liver transplant.
The side effects can include kidney problems and an increased risk of infections.
Bile duct leak or blockage
Sometimes a leak or blockage can occur in one of the bile ducts.
Bile is a fluid made by the liver to help with digestion. Bile passes from the liver into small tubes called bile ducts.
A bile leak can lead to abdominal discomfort, fever and infection. Ultimately a leak or blockage could result in graft failure.
You can download our information leaflet about liver transplants here: