16 December 2025 : Original article
Liver Transplantation for Combined Hepatocellular-Cholangiocarcinoma: A Retrospective Registry-Based Study Using the Korean Organ Transplant Registry (KOTRY)
Sang-Hoon Kim BCDEF 1, Shin Hwang ABG 1*, Bong-Wan Kim ABG 2, Dong Jin Joo ABD 3, Kwang-Woong Lee ABD 4, Gyu-Seong Choi AD 5, Je Ho Ryu ABD 6, Dong-Sik Kim ABD 7, Dongho Choi ABD 8, Jai Young Cho ABD 9, Young Kyoung You ABD 10, Dongho Choi ABD 11, Tae-Seok Kim ABD 12, PyoungJae Park ABD 13DOI: 10.12659/AOT.949241
Ann Transplant 2025; 30:e949241
Table 1 Baseline and clinicopathologic characteristics of recipients.
| Variable | N=40 |
|---|---|
| Sex | |
| Male (%) | 32 (80.0) |
| Female (%) | 8 (20.0) |
| Age (year) | 54.5 (49.3–59.8) |
| Etiology of liver disease | |
| Hepatitis B virus infection | 33 (82.5) |
| Hepatitis C virus infection | 1 (2.5) |
| Others | 6 (15.0) |
| MELD score | 9 (7–15) |
| Child-Pugh classification | |
| A | 24 (60.0) |
| B | 9 (22.5) |
| C | 7 (17.5) |
| Pre-LT ICU admission | 3 (7.5) |
| History of decompensation | |
| Ascites | 2 (5.0) |
| Variceal bleeding | 1 (2.5) |
| Hepatorenal syndrome | 0 |
| Hepatic encephalopathy | 0 |
| Pre-LT laboratory findings | |
| Total bilirubin (mg/dL) | 1.0 (0.7–2.0) |
| Albumin | 3.7 (3.0–4.1) |
| INR | 1.19 (1.09–1.37) |
| Pre-LT down staging treatment for liver cancer | |
| Liver resection | 8 (20.0) |
| TACE/TACI | 25 (62.5) |
| RFA | 4 (10.0) |
| Chemotherapy | 2 (5.0) |
| Radiotherapy | 7 (17.5) |
| Recurrence during follow-up | 9 (22.5) |
| Intrahepatic metastasis | 3 (7.5) |
| Extrahepatic metastasis | 5 (12.5) |
| Both intra- and extra-hepatic metastasis | 1 (2.5) |
| Recurrent sites | |
| Liver | 3 (7.5) |
| Liver and pleur | 1 (2.5) |
| Lung | 1 (2.5) |
| Lung and left adrenal gland | 1 (2.5) |
| Left adrenal gland | 1 (2.5) |
| Bone | 1 (2.5) |
| Peritoneal seeding | 1 (2.5) |
| Mortality during follow-up | 10 (25.0) |
| Causes of mortality | |
| Recurrent cancer | 4 (10.0) |
| Infection | 4 (10.0) |
| Pneumonia | 1 (2.5) |
| Aorto-esophageal fistula | 1 (2.5) |
| Follow-up period (months) | 21.4 (9.4–30.9) |
| Hospital stay (days) | 21 (17–28) |
| Preoperative tumor status | |
| Within Milan criteria | 23 (57.5) |
| Beyond Milan criteria | 17 (42.5) |
| Viable tumor number | |
| 1 | 18 (45.0) |
| 2 | 8 (20.0) |
| ≥3 | 14 (35.0) |
| Totally necrotic tumor number | |
| 0 | 31 (77.5) |
| 1 | 5 (12.5) |
| ≥2 | 4 (10.0) |
| Maximum tumor diameter | |
| ≤2 cm | 13 (32.5) |
| 2–5 cm | 24 (60.0) |
| >5 cm | 3 (7.5) |
| Sum of diameter of each tumor | 4.1 (2.7–5.7) |
| Differentiation (Edmondson-Steiner grade) | |
| I | 0 |
| II | 9 (23.7) |
| III | 21 (55.3) |
| IV | 8 (21.1) |
| Serosa invasion | 7 (17.5) |
| Peliosis or hemorrhage in tumor | 14 (35.0) |
| Fibrous capsule formation | 11 (27.5) |
| Septal formation | 6 (15.0) |
| Fatty change in tumor | 4 (10.0) |
| Capsule invasion | 13 (32.5) |
| Bile duct invasion | 3 (7.5) |
| Perineural invasion | 4 (10.0) |
| Portal vein invasion (portal vein tumor thrombosis) | 3 (7.5) |
| Macrovascular invasion | 4 (10.0) |
| Microvascular invasion | 19 (47.5) |
| Lymph node metastasis | 1 (2.5) |
| Extrahepatic metastasis | 0 |
| Satellite nodule | 9 (22.5) |
| Data are shown as median (interquartile range), mean±standard deviation, or n (%).ICU – intensive care unit; LT – liver transplantation; MELD – model for end-stage liver disease; INR – international normalized ratio; TACE – transcatheter arterial chemoembolization; TACI – transcatheter arterial chemoinfusion; RFA – radiofrequency ablation. | |