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Indications for liver transplantation in hepatobiliary malignancy

✍ Scribed by Dr. Rudolf Pichlmayr; Arved Weimann; Burckhardt Ringe


Publisher
John Wiley and Sons
Year
1994
Tongue
English
Weight
714 KB
Volume
20
Category
Article
ISSN
0270-9139

No coin nor oath required. For personal study only.

✦ Synopsis


Our personal experience with 172 patients, the results from the European Liver Transplant Registry and a review of the recent literature are summarized and discussed to define present indications for liver transplantation in hepatobiliary malignancy. The following conditions should be considered contraindications: advanced primary liver tumors with any extrahepatic spread, cholangiocellular carcinoma, hemangiosarcoma and liver metastases from nonendocrine primary tumor. Currently, "favorable" indications include uncommon tumors such as fibrolamellar carcinoma, epithelioid hemangioendothelioma, hepatoblastoma and metastases from endocrine tumors. Further indications may be nonresectable hepatocellular and proximal bile duct carcinoma in tumor stage 11. Borderline indications are hepatocellular and proximal bile duct carcinoma in tumor stage 111. In advanced tumors confined to the liver, transplantation should be restricted to multimodality treatment protocols. Although there are strong arguments for transplantation in early resectable hepatocellular carcinoma with underlying cirrhosis, it remains an open issue requiring further investigation in a controlled study using the same tumor classification. With regard to limited resources of donor organs, split-liver transplantation permits transplantation in tumor patients without neglecting those with benign diseases.


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