scholarly journals Treatment of a Giant Haemangioma of the Liver With Kasabach-Merritt Syndrome by Orthotopic Liver Transplant

HPB Surgery ◽  
1997 ◽  
Vol 10 (3) ◽  
pp. 159-162 ◽  
Author(s):  
J-H. Longeville ◽  
P. De La M. Hall ◽  
P. Dolan ◽  
A. W. Holt ◽  
P. E. Lillie ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Resection ◽  
Liver Transplant ◽  
Initial Treatment ◽  
Tooth Extraction ◽  
Orthotopic Liver Transplant ◽  
Cavernous Haemangioma ◽  
Disseminated Intravascular Coagulopathy ◽  
Intravascular Coagulopathy ◽  
Hepatic Haemangioma

We describe a case of giant cavernous haemangioma of the liver with disseminated intravascular coagulopathy (Kasabach-Merritt syndrome) which was cured by orthotopic liver transplant.A 47 year old man presented with bleeding and tender massive hepatomegaly after tooth extraction. Investigations showed disseminated intravascular coagulopathy and a giant hepatic haemangioma involving both lobes of the liver. Initial treatment failed to resolve the coagulopathy and liver resection was attempted. At laparotomy the turnout was unresectable and the only option for cure was to offer a liver transplantation. The orthotopic liver transplant was performed 20 days after initial laparotomy. Subsequently, all coagulation parameters returned to normal and the patient remains well after 12 months. Orthotopic liver transplant can be considered for giant hepatic haemangioma with Kasabach-Merritt syndrome when resection is necessary and a partial hepatectomy is not technically feasible.

scholarly journals Giant Hepatic Hemangioma With Kasabach–Merritt Syndrome: Is the Appropriate Treatment Enucleation or Liver Transplantation?

HPB Surgery ◽  
2000 ◽  
Vol 11 (6) ◽  
pp. 413-419 ◽  
Author(s):  
Steven N. Hochwald ◽  
Leslie H. Blumgart
Keyword(s):  
Liver Transplantation ◽  
Hepatic Hemangioma ◽  
Preoperative Preparation ◽  
Abdominal Girth ◽  
Disseminated Intravascular Coagulopathy ◽  
Postoperative Course ◽  
Appropriate Treatment ◽  
Intravascular Coagulopathy ◽  
Giant Hepatic Hemangioma ◽  
Hepatic Hemangiomas

We present a case of giant cavernous hemangioma of the liver with disseminated intravascular coagulopathy (Kasabach–Merritt syndrome) which was cured by enucleation. The 51 year old woman presented with increased abdominal girth and easy bruisability. Workup elsewhere revealed a massive hepatic hemangioma and she was started on radiation therapy to the lesion and offered an orthotopic liver transplant. After careful preoperative preparation, we felt that resection was possible and she underwent a successful enucleation. The operation and postoperative course were complicated by bleeding but she recovered and remains well in followup after 6 months. All coagulation parameters have returned to normal. Enucleation should be considered the treatment of choice for hepatic hemangiomas, including those presenting with Kasabach–Merritt syndrome. The benefits of enucleation as compared to liver transplantation for these lesions are discussed.

Outcomes of Patients With Familial Transthyretin Amyloidosis After Liver Transplantation

2017 ◽  
Vol 27 (3) ◽  
pp. 246-250 ◽  
Author(s):  
Dipti Banerjee ◽  
Lindsey E. Roeker ◽  
Martha Grogan ◽  
Paul Swiecicki ◽  
John Poterucha ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Overall Survival ◽  
Liver Transplant ◽  
Research Question ◽  
Organ Transplant ◽  
Early Death ◽  
Multiple Organ ◽  
Orthotopic Liver Transplant ◽  
Transthyretin Amyloidosis ◽  
Organ Systems

Background: Familial transthyretin amyloidosis is a disease caused by misfolded transthyretin aggregates that can impair multiple organ systems. Liver transplantation is the first-line treatment for familial transthyretin amyloidosis. Research Question: Our objective is to study outcomes and survival among patients with familial transthyretin amyloidosis after transplantation. Design: All patients undergoing orthotopic liver transplant for familial transthyretin amyloidosis at Mayo Clinic between 1997 and 2012 were reviewed. Baseline clinical characteristics, organs transplanted, and posttransplant clinical course were assessed. Results: Of the 40 patients, 7 patients had the V30M mutation and 33 had other mutations. Nineteen patients received liver only, 19 liver and heart, and 2 combined liver, heart, and kidney transplants. The 5-year overall survival was 85% for those receiving multiple organ transplant and 52% for those receiving liver transplant only ( P = .057). There was no difference in overall survival based on mutation (V30M vs other mutations), but survival was confounded by varied disease involvement and organs transplanted. Those who had early death (≤24 months from liver transplant) had a higher incidence of baseline peripheral neuropathy, autonomic neuropathy, lower modified BMI, and higher alkaline phosphatase. Discussion: Outcomes of orthotopic liver transplant in familial transthyretin amyloidosis are variable due to heterogeneity in mutations and patient status at the time of transplant. Familial transthyretin amyloidosis can progress, despite liver transplantation. Patients receiving combined liver, heart/kidney transplant demonstrated improved survival compared to liver transplant alone.

scholarly journals Uncommon Occurrence of an Air Embolism during the Preanhepatic Phase of an Orthotopic Liver Transplant

2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Klint J. Smart ◽  
Saman Yaghoubian
Keyword(s):  
Liver Transplantation ◽  
Case Report ◽  
Liver Transplant ◽  
Air Embolism ◽  
Air Entrainment ◽  
Neurological Complications ◽  
Orthotopic Liver Transplant ◽  
Hemodynamic Support ◽  
Air Embolus

Vascular air embolism (VAE) during liver transplantation usually occurs during the dissection phase of the procedure or during liver reperfusion. If this phenomenon occurs, it can cause significant cardiovascular, pulmonary, and neurological complications. Prompt identification of VAE is essential, and the surgeon should be immediately notified. The mainstay treatment is identification and rectification of the source of the air embolus, hemodynamic support, and prevention of further air entrainment. This case report describes the occurrence of a pulmonary air embolism during the preanhepatic phase of an orthotopic liver transplant.

Improved survival outcomes for orthotopic liver transplant (OLT): 12 years experience at Irish transplant

Endoscopy ◽  
2005 ◽  
Vol 37 (05) ◽  
Author(s):  
A Qasim ◽  
B Zaman ◽  
B Blake ◽  
T Tajuddin ◽  
J Geoghegan ◽  
...  
Keyword(s):  
Liver Transplant ◽  
Orthotopic Liver Transplant ◽  
Survival Outcomes

scholarly journals The Treatment Effect of Liver Transplantation versus Liver Resection for HCC: A Review and Future Perspectives

Cancers ◽  
2021 ◽  
Vol 13 (15) ◽  
pp. 3730
Author(s):  
Berend R. Beumer ◽  
Roeland F. de Wilde ◽  
Herold J. Metselaar ◽  
Robert A. de Man ◽  
Wojciech G. Polak ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Liver Resection ◽  
Early Stage ◽  
Disease Free Survival ◽  
Milan Criteria ◽  
Term Survival ◽  
Equal Distribution ◽  
Intention To Treat ◽  
Treat Analysis

For patients presenting with hepatocellular carcinoma within the Milan criteria, either liver resection or liver transplantation can be performed. However, to what extent either of these treatment options is superior in terms of long-term survival is unknown. Obviously, the comparison of these treatments is complicated by several selection processes. In this article, we comprehensively review the current literature with a focus on factors accounting for selection bias. Thus far, studies that did not perform an intention-to-treat analysis conclude that liver transplantation is superior to liver resection for early-stage hepatocellular carcinoma. In contrast, studies performing an intention-to-treat analysis state that survival is comparable between both modalities. Furthermore, all studies demonstrate that disease-free survival is longer after liver transplantation compared to liver resection. With respect to the latter, implications of recurrences for survival are rarely discussed. Heterogeneous treatment effects and logical inconsistencies indicate that studies with a higher level of evidence are needed to determine if liver transplantation offers a survival benefit over liver resection. However, randomised controlled trials, as the golden standard, are believed to be infeasible. Therefore, we suggest an alternative research design from the causal inference literature. The rationale for a regression discontinuity design that exploits the natural experiment created by the widely adopted Milan criteria will be discussed. In this type of study, the analysis is focused on liver transplantation patients just within the Milan criteria and liver resection patients just outside, hereby ensuring equal distribution of confounders.

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