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Introduction There is still no consensus about the actual role of liver transplantation (LT) in the therapeutic algorithm of combined hepatocellular-cholangiocarcinoma (cHCC-CC) because of low incidence and few clinical information. Methods We retrospectively identified 111 patients at nine centers from 2001 to 2019 in Korea. Results Of the 111 patients, 85.6% (n = 95) was male and the median age was 54 years (range, 31-66 years). HBV is 82% (n = 91) and HCC is 96% (86.3%) preoperatively. Seventy-four patients (66.7%) received locoregional therapy (LRT) before LT. Median tumor size was 2.5 cm (range, 0.5-7.2 cm) and the ratio of beyond Milan criteria was 40.5% (n = 45). The 1-year, 3-year, and 5-year disease-free survival rates and tumor-related patient survival rates were 77.6%, 56.3%, and 51.1% and 84.4%, 63.8%, and 56.7%, respectively. The extrahepatic site was 75.5% as an initial tumor recurrence site in recurrent tumor patients. Numbers of LRT before LT > 3 and tumor size > 3 cm were closely associated tumor recurrence and early tumor recurrence within 1 year after LT. Tumor size > 3 cm was only predisposing factor for tumor-related death. Conclusions It is difficult to diagnose cHCC-CC before LT, but a good prognosis can be expected if the tumor size is less than 3 cm in pathology.

Introduction Old donors have gradually been used as an alternative living liver donor to alleviate the organ shortage or avoid offspring donation. The aim of the present study is to determine the impact of elderly donors more than 60 years in living donor liver transplantation (LDLT) on donor safety and recipient outcomes compared with donors from fifty to fifty-nine years. Methods We retrospectively identified 209 patients at nine centers from 2005 to 2017 in Korea. Results Sixty group represented 10.0% (n = 21) of the patient donors. The incidence of male donor in the sixty group was higher than in the fifty group (61.9% vs. 37.8%; p = 0.039). Postoperative complications were more common in the sixty group. There was no in-hospital mortality and no mortality was reported during the observation period. There were no statistically significant differences in operation time, blood loss, intraoperative and postoperative transfusion rate, postoperative total bilirubin, and hospitalization between the two groups. In recipient operation, median blood loss, transfusion rates during operation, and postoperative bleeding control operations were more than in the fifty group. Postoperative total bilirubin and hospitalization in the sixty group were higher and longer in the fifty group. Cumulative patient survival rate in the fifty group was better than in the sixty group (p = 0.011). Sixty group was predisposing factor for recipient death in multivariate analysis. Conclusions Present study suggests that highly selected elderly living donors (≥ 60 years) can safely donate, but their recipient outcomes are worse compared with the fifty group.