Pet/ct positivity: indicator of low survival rate in adult, living donor liver transplant caused by hepatocelluler carcinoma

The role of the PET/CT for clinical staging of HCC, patient selection for liver transplantation, recurrence and predictionof survival is controversial. Aim To evaluate the relationbetween FDG positivity and recurrence, survival andhistopathology in living donor liver transplantation. All patients with HCC who underwent living donor liver transplantation(LDLT) between June 2011 and December 2013were retrospectively analyzed. Imaging data, differantiation, AFP, number of tumors and size, recurrence and survival werereported and correlated to FDG-PET CT scanning. There were 60 patients, in a mean age of 53.8±7.99 years and the meanfollow-up of all patients was 20.6±10.96 months. The comparisonof the results between PET/CT negative and positivepatients have shown that the maximum tumor size was largerin PET/CT positive vs negatives (p= 0.04), PET-positive patientshad higher mortality and recurrence rates than PET/CT negativepatients (p<0.05), One-year survival was significantlylower in PET/CT positive patients vs negatives (82% vs 100%, p=0.04), However, there were no differences accordingto AFP, grade and microvasculare invasion (p>0.05). The present study has shown that pre-transplant PET/CTpositivity is a marker of poor prognosis of HCC and showslower survival and higher tumor recurrence rates after LDLT. However, especially in pre-transplant setting, its role should bestudied with higher number of patients.