Abstract: Liver transplantation (LT) represents one of the most effective radical therapy for hepatocellular carcinoma (HCC), particularly for advanced HCC. With the standardized development of organ acquisition and transplantation, the number of LT for HCC in China has far exceeded that of the United States in the past five years. However, postoperative recurrence and metastasis remains the key issues to improve the long-term prognosis. Meanwhile, immunosuppressive regimens based on calcineurin inhibitors are considered to be an independent risk factor of tumor recurrence after LT for HCC, early rapamycin conversion therapy is currently recommended for immunosuppression in recommended so as to avoid long-term high exposure to hormones and calcineurin inhibitors. Nevertheless, this option failed to improve the long-term survival of 3 to 5 years or the benefit was limited. Therefore, it is important and urgent to establish a personalized comprehensive prevention and treatment system to maximize the survival benefit of rapamycin and delay the recurrence of HCC. Based on the recent progress of HCC treatment including LT, targeted therapy and biological immunotherapy, our study aims to explore the necessity of establishing a comprehensive prevention and treatment system of tumor recurrence after LT.

Key words: Primary liver cancer, Liver transplantation, Rapamycin, Tumor recurrence, Targeted therapy