Liver tumors and liver transplantation

Abernethy malformation or congenital agenesis of the portal vein (CAPV) is a rare malformation of the abdominal splanchnic venous system. This malformation is commonly found in children and is often associated with other malformations such as congenital cardiac anomalies and skeletal system disorders, as well as liver tumors. There are two types of Abernethy malformation. In type I, portal blood bypasses the liver completely, with the superior mesenteric vein and the splenic vein draining into the inferior vena cava separately (type Ia), or together (type Ib). There are no intrahepatic portal vein branches in the liver. Type II is a partial portocaval shunt in which portal blood partially supplies the liver. There is no unified therapeutic approach for all patients with Abernethy malformation, however, liver transplantation is recommended in patients with liver disease (encephalopathy, poor liver function) and those with liver tumors. In this case report we present a case of Abernethy type Ib malformation in a 17-year-old patient with chronic malaise and uper abdominal pain. During diagnostic work-up, an unresectable liver tumor was found and the patient was successfully treated with orthotopic liver transplantation.

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Living-related liver transplant to treat epithelioid hemangioendothelioma – a case report

Brazilian Journal of Transplantation ◽

10.53855/bjt.v8i4.383 ◽

2005 ◽

Vol 8 (4) ◽

pp. 449-451

Author(s):

Marcelo A. F. Ribeiro Jr ◽

Christian Evangelista Garcia ◽

Telma Eugênio dos Santos ◽

Adavio de Oliveira e Silva ◽

Regina Leitão ◽

...

Keyword(s):

Liver Transplantation ◽

Case Report ◽

Liver Transplant ◽

Soft Tissues ◽

Liver Tumors ◽

Epithelioid Hemangioendothelioma ◽

Low Grade ◽

Living Related Liver Transplant ◽

Transplantation Technique ◽

Living Related

Introduction: Epithelioid hemangioendothelioma of liver is a rare, low-grade neoplasm of vascular origin that has an unpredictable malignant potential. It preferentially arises in soft tissues and bones, and seldom in the liver. Biologically, it trends to be multi-focal and often unresectable. Objective: The outcome of a patient submitted to a living-related liver transplant to treat epithelioid hemangioendothelioma of the liver. Case report: The reported case involves a 39-year old female patient with an immense epithelioid hemangioendothelioma of the liver, involving segments III, IV, V, VII, and VIIl. The prognostic to any kind of treatment was considered unfavorable, and the decision of submitting her to a liver transplant was made. It was suggested a living-related liver transplant. The donor was the patient’s 36-year old brother, who donated his right liver lobe (segments V, VI, VII, VIII). The recipient´s original liver was large, presenting very solid consistence and no node evidence. The transplant itself was performed using the conventional living-related liver transplantation technique. The recovery was good, and she was discharged from hospital on the 15th postoperative day using micophenolate mofetil, tacrolimus, and corticoid. Conclusion: Liver transplantation for epithelioid hemangioendothelioma of the liver can be performed with acceptable survival rate. The living related liver transplant opens a great perspective to that group of patients presenting liver tumors and who are unfeasible to wait for an organ on a waiting list.

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Multi-Center Analysis of Liver Transplantation for Combined Hepatocellular Carcinoma-Cholangiocarcinoma Liver Tumors

Journal of the American College of Surgeons ◽

10.1016/j.jamcollsurg.2020.11.017 ◽

2020 ◽

Author(s):

Leigh Anne Dageforde ◽

Neeta Vachharajani ◽

Parissa Tabrizian ◽

Vatche Agopian ◽

Karim Halazun ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Transplantation ◽

Liver Tumors

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Liver transplantation for metastatic liver tumors

Hepatology Research ◽

10.1111/hepr.12901 ◽

2017 ◽

Vol 47 (7) ◽

pp. 616-621 ◽

Cited By ~ 1

Author(s):

Susumu Eguchi ◽

Takanobu Hara ◽

Mitsuhisa Takatsuki

Keyword(s):

Liver Transplantation ◽

Liver Tumors ◽

Metastatic Liver Tumors ◽

Metastatic Liver

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Percutaneous liquid ablation agent for tumor treatment and drug delivery

Science Translational Medicine ◽

10.1126/scitranslmed.abe3889 ◽

2021 ◽

Vol 13 (580) ◽

pp. eabe3889

Author(s):

Hassan Albadawi ◽

Zefu Zhang ◽

Izzet Altun ◽

Jingjie Hu ◽

Leila Jamal ◽

...

Keyword(s):

Liver Transplantation ◽

Ionic Liquid ◽

Liver Tumor ◽

Thermal Ablation ◽

Liver Tumors ◽

Low Cost ◽

Drug Distribution ◽

Tumor Model ◽

Ablation Zone ◽

Synergistic Cytotoxicity

Percutaneous locoregional therapies (LRTs), such as thermal ablation, are performed to limit the progression of hepatocellular carcinoma (HCC) and offer a bridge for patients waiting for liver transplantation. However, physiological challenges related to tumor location, size, and existence of multiple lesions as well as safety concerns related to potential thermal injury to adjacent tissues may preclude the use of thermal ablation or lead to its failure. Here, we showed a successful injection of an ionic liquid into tissue under image guidance, ablation of tumors in response to the injected ionic liquid, and persistence (28 days) of coinjected chemotherapy with the ionic liquid in the ablation zone. In a rat HCC model, the rabbit VX2 liver tumor model, and 12 human resected tumors, injection of the ionic liquid led to consistent tumor ablation. Combining the ionic liquid with the chemotherapy agent, doxorubicin, resulted in synergistic cytotoxicity when tested with cultured HCC cells and uniform drug distribution throughout the ablation zone when percutaneously injected into liver tumors in the rabbit liver tumor model. Because this ionic liquid preparation is simple to use, is efficacious, and has a low cost, we propose that this new LRT may bridge more patients to liver transplantation.

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Liver Transplantation for Pediatric Liver Cancer

Cancers ◽

10.3390/cancers12030720 ◽

2020 ◽

Vol 12 (3) ◽

pp. 720 ◽

Cited By ~ 3

Author(s):

Rakesh Sindhi ◽

Vinayak Rohan ◽

Andrew Bukowinski ◽

Sameh Tadros ◽

Jean de Ville de Goyet ◽

...

Keyword(s):

Liver Transplantation ◽

Liver Cancer ◽

Liver Tumors ◽

Current Knowledge ◽

Tumor Staging ◽

Steady Increase ◽

Malignant Rhabdoid Tumor ◽

Diagnostic Uncertainty ◽

Pediatric Liver ◽

Improvement In Survival

Unresectable hepatocellular carcinoma (HCC) was first removed successfully with total hepatectomy and liver transplantation (LT) in a child over five decades ago. Since then, children with unresectable liver cancer have benefitted greatly from LT and a confluence of several equally important endeavors. Regional and trans-continental collaborations have accelerated the development and standardization of chemotherapy regimens, which provide disease control to enable LT, and also serve as a test of unresectability. In the process, tumor histology, imaging protocols, and tumor staging have also matured to better assess response and LT candidacy. Significant trends include a steady increase in the incidence of and use of LT for hepatoblastoma, and a significant improvement in survival after LT for HCC with each decade. Although LT is curative for most unresectable primary liver sarcomas, such as embryonal sarcoma, the malignant rhabdoid tumor appears relapse-prone despite chemotherapy and LT. Pediatric liver tumors remain rare, and diagnostic uncertainty in some settings can potentially delay treatment or lead to the selection of less effective chemotherapy. We review the current knowledge relevant to diagnosis, LT candidacy, and post-transplant outcomes for these tumors, emphasizing recent observations made from large registries or larger series.

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Integrative Concepts for Liver Surgery

Visceral Medicine ◽

10.1159/000511043 ◽

2020 ◽

Vol 36 (5) ◽

pp. 351-358

Author(s):

Stefan Heinrich ◽

Felix Watzka ◽

Hauke Lang

Keyword(s):

Liver Transplantation ◽

Patient Selection ◽

Liver Surgery ◽

Liver Tumors ◽

Treatment Options ◽

Molecular Characteristics ◽

Primary Tumors ◽

Primary Liver Tumors ◽

Liver Resections ◽

Systemic Treatments

Background: Surgery is the standard treatment for primary tumors and metastases. Due to improvements in surgical outcomes as well as the efficacy of systemic treatments, the role of surgery has changed in recent years. Summary: Liver surgery has become safe and efficient, with resectability being increased by multimodality concepts as well as staged liver resections and orthotopic liver transplantation. These concepts may be applied to primary liver tumors but also to selected patients with liver metastases from various diseases. In addition, even debulking surgery may be indicated for selected patients with endocrine metastases. While patient selection for liver resections was limited to clinical parameters in the past, histological and molecular characteristics have become increasingly important. Moreover, the response to regional or systemic chemotherapy has been demonstrated to be strong for a beneficial course of the disease even in advanced diseases. Key-Messages: Due to the variety of available treatment options, optimal patient selection is crucial. Besides liver surgery, staged concepts as well as liver transplantation are curative tools for many patients.

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Accuracy of computerized tomography in determining hepatic tumor size in patients receiving liver transplantation or resection.

Journal of Clinical Oncology ◽

10.1200/jco.1984.2.6.637 ◽

1984 ◽

Vol 2 (6) ◽

pp. 637-642 ◽

Cited By ~ 18

Author(s):

R Mittal ◽

C Kowal ◽

T Starzl ◽

D Van Thiel ◽

K Bron ◽

...

Keyword(s):

Liver Transplantation ◽

Hepatic Resection ◽

Computerized Tomography ◽

Liver Tumors ◽

Imaging Techniques ◽

Hepatic Metastases ◽

Response To Treatment ◽

Preoperative Ct ◽

Malignant Liver ◽

The Impact

Computerized tomography (CT) of liver is used in oncologic practice for staging tumors, evaluating response to treatment, and screening patients for hepatic resection. Because of the impact of CT liver scan on major treatment decisions, it is important to assess its accuracy. Patients undergoing liver transplantation or resection provide a unique opportunity to test the accuracy of hepatic-imaging techniques by comparison of findings of preoperative CT scan with those at gross pathologic examination of resected specimens. Forty-one patients who had partial hepatic resection (34 patients) or liver transplantation (eight patients) for malignant (30 patients) or benign (11 patients) tumors were evaluable. Eight (47%) of 17 patients with primary malignant liver tumors, four (31%) of 13 patients with metastatic liver tumors, and two (20%) of 10 patients with benign liver tumors had tumor nodules in resected specimens that were not apparent on preoperative CT studies. These nodules varied in size from 0.1 to 1.6 cm. While 11 of 14 of these nodules were less than 1.0 cm, three of 14 were greater than 1.0 cm. These results suggest that conventional CT alone may be insufficient to accurately determine the presence or absence of liver metastases, extent of liver involvement, or response of hepatic metastases to treatment.

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