Objective To analyze the independent risk factors for achieving a textbook outcome(TO)in liver transplant(LT)surgery for patients with hepatocellular carcinoma.Methods Retrospective analysis of clinical diagnosis and treatment data of patients with HCC who underwent LT in the Liver Transplantation Department of Sun Yat-sen Memorial Hospital,Sun Yat-sen University from June 2019 to December 2022 was performed.A total of 134 patients were included,including 124 males and 10 females,with a median age of 54(47～60)years.According to whether TO was achieved,they were divided into the TO group(n=41)and the non-TO group(n=93).Univariate and multivariate logistic regression analyses were used to identify independent factors affecting TO.Results Approximately one-third(30.6％)of hepatocellular carcinoma patients achieved tumor obliteration(TO)after liver transplantation(LT).Multivariate analysis showed that preoperative bilirubin≥54.1 mmol/L(OR=9.75,95％CI=2.01～47.28,P=0.005)and biliary stasis in donor liver(OR=2.93,95％CI=1.21～7.13,P=0.018)were independent risk factors for achieving TO.Further analysis revealed no statistical difference in long-term survival rates between the TO group and non-TO group(x2=1.127,P=0.288).Conclusion Preoperative high serum bilirubin and cholestasis in the donor liver are independent risk factors for achieving TO after liver transplantation in patients with hepatocellular carcinoma.Currently,no differences have been found in the long-term survival rates between different groups.As a comprehensive indicator of short-term prognosis,TO can be used to compare the quality of nursing among different centers after liver transplantation..
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