Efficacy and Safety of Lenvatinib for the Treatment of Recurrent Hepatocellular Carcinoma After Living Donor Liver Transplantation: A Report of Two Cases

Recurrence of hepatocellular carcinoma (HCC) after liver transplantation (LT) is one of the main causes of death after LT, and patient prognosis is reportedly poor. Herein, we report two cases of unresectable HCC recurrences after living donor LT that were treated effectively and safely with lenvatinib.Both cases underwent LT for HCC beyond the Milan criteria. About 2 years following LT, HCC recurrences were found and resected. However, unresectable 2nd-recurrences were found several months after surgery. In the first case, a complete response was maintained for 12 months with transarterial chemoembolization and lenvatinib. In the second case, a partial response was maintained for 5 months with lenvatinib. Severe adverse events were not observed in either case.The presently reported cases suggest that lenvatinib might be effective for the treatment of unresectable HCC recurrence after LT.