Introduction : Liver transplantation has been widely spread all over the world, as the only curative treatment for end-stage liver disease. Statins, 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors, have been reported to prevent the progression of hepatocellular carcinoma (HCC). There are many factors that affect the recurrence of HCC, but the role of statin is not known precisely. Therefore, we examined whether statin therapy is associated with decreased HCC recurrence in patients who underwent living donor liver transplantation (LDLT) for HCC.

Methods : We retrospectively analyzed 844 HCC patients of primary adult-to-adult LDLT in our center between January 2007 and December 2016. Of these, deceased donor liver transplantation (DDLT), pediatric cases, re- or re-retransplantations and a case of LDLT from reason other than HCC, were excluded. Statin therapy was defined as the administration of statins for more than 30 cumulative defined daily doses (cDDD) after liver transplantation.

Results : Recipients were devided into 2 groups, Non-statins group (n=324) and statin group (n=62). There was significant difference in HBsAg positive rates between the two groups (p=0.010). Result of multivariable analysis for HCC recurrence, HBsAg positive recipient rates (p=0.027), loco-regional therapies (>3 times, p=0.007), AFP levels (>100, p=0.006), micro vessel invasion (p=0.000) was significantly different between the non-recur group (n=273) and recur group (n=113). And cox regression analysis showed that statin treatment was associated with significantly lower recurrence risk of HCC after adjusting for other risk factors. (p=0.004, hazard ratio=0.368, 95% CI =0.185-0.729)

Conclusions : Statin use is associated with low HCC recurrence in LT recipients.