Interview with Prof. Mobin Khan in the APASL2009

Hepatology Digest: I’m here with Professor Mobin Khan. Thank you for joining us today here at APASL, Professor Khan.

Prof. Khan: Thank you very much.

Hepatology Digest: It’s a great honour to interview you today. I’d like to ask you the first question regarding HCC – I suppose it’s a fairly new idea that HCC is suitable for liver transplantation so which kind of HCC patients are most suitable for transplantation?

Prof. Khan:  If the patient has one or two lesions lower than 2.5 centimetres in size in one lobe, this is a more convenient patient for transplantation.

Hepatology Digest: I heard a talk here at the conference about selection criteria for transplantation and some are obviously a little bit more inclusive than others, for example the Hangzhou and others, how do apply the criteria with regards to HCC? Are you very strict in that rule that you just mentioned?

Prof. Khan:  You used to obey the rule because the patient will survive longer, no complications, no recurrence if the transplantation is done earlier. Therefore it should be located in one lobe, smaller in size and not more than two or three in number.

Hepatology Digest: So what are the main factors that may decrease the donor-recipient’s survival?

Prof. Khan: The recipient’s survival will depend upon whether the  patient has developed distribution of the disease to other organs; or there are distant metastises; or (….) both the lobes are involved; large size tumour; with associated complications.

Hepatology Digest: Since the recurrence of HCC is one of the most important factors for survival of HCC patients, what is the record and in general your experience perhaps with survival of HCC patients after liver transplantation? How long is their survival generally?

Prof. Khan: Survival is not longer if the tumour size is bigger; if it has distributed to two lobes of the liver. But the chance of survival is good if the tumour size is small in one lobe and the patient is younger, more survival is expected to occur.  Survival is from 60-65% in normal situations.

Hepatology Digest: Many HCC patients die from their HCC recurrence so what do you think might be some effective ways or the best ways to reduce the recurrence of HCC after liver transplantation?

Prof. Khan: It is the supervision of the patient, the follow-up of the patient which may help in reducing the recurrence or treating the patient at an early stage after transplantation.

Hepatology Digest: And are there any special local conditions that perhaps that you face in your country that we don’t see in China or more east Asia versus south Asia, India and Bangladesh. Are there any differences in treatment and problems that you might face locally?

Prof. Khan: The highest problem is that the patient comes at a later stage and general condition is poor, advanced cirrhosis of the liver is common, therefore the survival is reduced by the initial complications.

Hepatology Digest: The theme here at the 19th APASL is a multidisciplinary approach to clinical  hepatology so in this context, how can we carry out prevention and treatment of HCC in a real multidisciplinary way?

Prof. Khan: First and foremost is that the follow-up of the patient is essential. The patient should be followed at least a 3 month interval and an ultrasonagram should be performed at 6 months interval so that early detection of the tumour at a smaller size will help in prolonging the lifetime of the patient. Early detection is safe for the patient.

Hepatology Digest: Professor Khan, it was a real pleasure speaking to you today. Thank you for joining us here at APASL.

Prof. Khan: Thank you as well. Thank you very much.