Lenvatinib Following Liver Transplantation in Patients With High-Risk Hepatocellular Carcinoma

Inclusion Criteria: * Patients at high risk of recurrence of hepatocellular carcinoma after liver transplantation: extended Milan criteria, without vascular invasion (except for microvascular invasion suggested by pathology after operation) * Male or female patients aged 18 to 75. * ECOG physical condition was 0-2 points. * Child-Pugh A grade of liver function. * Targeted therapy is acceptable within 1-2 months after liver transplantation. ⑥Immunosuppressive regimen consists of calcineurin inhibitor, mycophenolate mofetil and sirolimus. ⑦No history of surgical resection of liver tumors and targeted drug therapy before liver transplantation. ⑧Good liver, kidney and bone marrow function: serum albumin \> 28g/L, total bilirubin ≤ 3 mg/dL (51.3 umol/l), ALT and AST ≤ 5 times the upper limit of normal range; serum creatinine ≤ 1.5 times the upper limit of normal range; hemoglobin \> 90 g/L, neutrophil count (ANC) \> 1.5 \* 10 \^ 9/L, platelet count \> 60 \* 10 \^ 9/L; PT-INR \< 2.3, or PT within 6 seconds over normal upper limit. ⑧For fertile female patients, the serum/urine pregnancy test should be negative within 7 days before treatment. ⑨All male and female participants must take reliable contraceptive measures during the trial and within four weeks after the end of the trial. ⑩The participants have the capability of oral medication. ⑾The participants must sign the consent form. Exclusion Criteria: * Life expectancy is less than 3 months * The recurrence and metastasis of hepatocellular carcinoma are highly suspected. * Patients are with other malignant tumors simultaneously. * Patients are anaphylaxis to the inactive ingredients of lenvatinib or drugs. * Pregnant or lactating women (Female participants need pregnancy test within 7 days before treatment). * Preoperative history of severe cardiovascular disease: congestive heart failure \> NYHA grade 2; active coronary heart disease (myocardial infarction occurred within 6 months before entry into the study); severe arrhythmia requiring antiarrhythmic treatment (allowable use of beta-blockers or digoxin); uncontrolled hypertension. * History of HIV infection. ⑧Severe clinical active infections (\> NCI-CTCAE version 3.0). ⑨Epilepsy patients requires medication (e.g. steroids or antiepileptic drugs). ⑩Patients with kidney diseases requires renal dialysis. ⑾Drug abuse, medical symptoms, mental illness or social status that may interfere with participants'participation in research or evaluation of research results. ⑿Patients who could not swallow oral drugs, such as those with severe upper gastrointestinal obstruction and need gastric tube feeding. ⒀Other anti-angiogenesis therapies, surgery, TACE, local therapy and systemic chemotherapy were given before the treatment after liver transplantation.