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Content: Objective: Clinic-pathologic characteristic of hepatocellular carcinoma are mostly accounting for the tumor recurrence after liver transplantation. It is assumed that tumor angiogenesis capability contributes to the rates of post-transplant relapse, as well. The aim of study was to evaluate the contribution of the circulating hematopoietic stem cells (HSCs); endothelial progenitor cells (EPCs) and serum vascular endothelial growth factor (VEGF) to the recurrence of HCC after liver transplantation. Methods: The study was carried out on 49 cirrhotic patients with HCC within the Milan criteria. They were transplanted in 2009 and followed-up for 54 months, so far. The rates of circulating HSCs and EPCs were assessed through a phenotypic analysis of 2 ml of fresh blood in a flow cytometer. Serum VEGF concentration was measured by enzyme-linked immunoassay (ELISA). Histopathology examination of the liver explants was performed for tumor characteristic. The data were analyzed with statistical tests. Results: There were 9 deaths related to the procedure. Of 40 remaining patients the tumor recurred in 6 (15%) prior to 36 months and then in 5 (12.5%) prior to 54 months of observation. The pre-transplant rates of circulating HSCs and EPCs were significantly higher in patients with tumor relapse; Chisq=17.25, p<0.001 and Chisq=13.96, p<0.001, respectively. The differences in the serum VEGF concentration were not significant in this group, however. Conclusion: Tumor angiogenesis capability should be considered as the predictive factor of tumor relapse after liver transplantation.
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