肝细胞癌患者的肝移植涉及三种主要类型的供体异体移植：脑死亡后捐赠、心脏死亡后捐赠和脑死亡和心脏死亡后捐赠。关于肝细胞癌患者接受这些异体移植后的移植结果存在争议，且相关数据非常有限。我们对浙江树兰（杭州）医院2015年至2021年接受肝移植的490例肝细胞癌患者的数据进行了回顾性分析。根据移植类型，参与者分别被分为三组：脑死亡后捐赠组、心脏死亡后捐赠组和脑死亡和心脏死亡后捐赠组。应用Kaplan-Meier和Cox回归方法评估了肝移植后患者的存活率、移植物存活率和无复发生存率。Kaplan-Meier分析显示，脑死亡后捐赠组的3年患者生存率为69.2％，心脏死亡后捐赠组为69.2％，脑死亡和心脏死亡后捐赠组为46.6％（P = .42）；3年移植物存活率分别为53.3％、56.4％和46.6％（P = .44）；而3年无复发生存率分别为55％、56.6％和39.5％（P = .46）。三组之间并发症发生率也相似（P = .36）。多元回归分析显示，术中红细胞输血（风险比：1.820；P = .042）和早期移植物功能障碍（风险比：3.240；P = .041）是移植物存活的独立危险因素。当使用严格的供体选择标准时，肝细胞癌患者接受脑死亡后捐赠、心脏死亡后捐赠或脑死亡和心脏死亡后捐赠异体移植均可获得相似的结果。

Liver transplant for patients with hepatocellular carcinoma involves 3 main types of donor allografts: donation after brain death, donation after cardiac death, and donation after brain and cardiac death. Data on this topic are limited, and controversies exist regarding liver transplant outcomes in hepatocellular carcinoma patients who have received these allografts.Data from 490 hepatocellular carcinoma patients who received liver transplant from 2015 to 2021 at the Shulan (Hangzhou) Hospital were retrospectively analyzed. Participants were divided into 3 cohorts according to allograft type: donation after brain death, donation after cardiac death, and donation after brain and cardiac death. Kaplan-Meier and Cox regression methods were used to evaluate patient survival, graft survival, and recurrence-free survival rates after liver transplant.Kaplan-Meier analysis revealed that 3-year patient survival rates were 69.2% for donations after brain death, 69.2% for donations after cardiac death, and 46.6% for donations after brain and cardiac death (P = .42); the 3-year graft survival rates were 53.3% for donations after brain death, 56.4% for donations after cardiac death, and 46.6% for donations after brain and cardiac death (P = .44); and 3-year recurrence-free survival rates were 55% for donations after brain death, 56.6% for donations after cardiac death, and 39.5% for donations after brain and cardiac death (P = .46). Complications were also similar across the 3 cohorts (P = .36). Multivariable analysis showed that intraoperative red blood cell transfusion (hazard ratio: 1.820; P = .042) and early allograft dysfunction (hazard ratio: 3.240; P = .041) were independent risk factors for graft survival.Similar outcomes can be achieved for hepatocellular carcinoma patients who undergo liver transplant with donations after brain death, donations after cardiac death, or donations after brain and cardiac death allografts, especially when strict donor selection criteria are applied.