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Incidental Cholangiocarcinoma is Associated with Poor Outcome in Patients Transplanted for Hepatocellular Carcinoma

Rustam Khan, Safia Awan, Peng Chung Cheow, Chee Kiat Tan and Pik Eu Chang

Background: Hepatocellular carcinoma (HCC) is a common malignancy in Asia for which orthotopic liver transplantation (OLT) offers curative treatment in selected patients. Incidental HCC-cholangiocarcinoma (HCC-CLC) has been associated with poor OLT outcomes. Aims: To examine the prevalence of incidental HCC-CLC in liver explants from patients undergoing liver transplantation for HCC in our center and to examine its association with post-transplant disease recurrence and mortality. Methods: Medical records of all liver transplant patients in our center were reviewed. The presence of HCC-CLC in liver explants was reviewed by experienced pathologists. Factors associated with recurrence of HCC post OLT and post-transplant mortality were analyzed. Survival in patients with incidental HCC-CLC was compared against those without.