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 20 November 2017

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News

'Unwanted livers' for hepatocellular cancer in cirrhosis

Liver transplantation with 'livers that nobody wants' constitutes an additional option for patients with hepatocellular carcinomas and cirrhosis, finds this month's issue of Transplantation.

News image

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Liver transplantation is recognized as the treatment of choice for small hepatocellular carcinomas in patients with end-stage liver failure.

However, because of limited organ availability, not all those who qualify can benefit from it.

Dr Georgios Sotiropoulos and colleagues accepted and transplanted 10 deceased donor liver allografts over a 3-year period.

The donor liver allografts were allocated through Eurotransplant.

These organs had previously been officially offered to and rejected by other transplant centers a total of 40 times due to medical or logistical reasons.

The investigators implanted these livers into patients in the waiting list with hepatocellular carcinomas and cirrhosis.

Recipients without hepatocellular carcinomas transplanted with such "undesirable" grafts were not included in this study.

The investigative team observed that 2 patients had initial poor graft function but subsequently recovered.

All patients are currently alive, with follow-up periods from 5 to 36 months
Transplantation

There was 1 arterial complication requiring reintervention.

The team noted that median intensive care unit and hospital stays were 6 and 28 days, respectively.

The investigators reported that 1 patient developed renal insufficiency, but recovered after 3 months.

Another patient had hepatocellular carcinoma recurrence in the allograft and underwent a successful atypical liver resection 23 months after transplantation.

The investigators reported that all patients are currently alive, with follow-up periods ranging from 5 to 36 months.”

Dr Sotiropoulos' team commented, “Liver transplantation with such 'livers that nobody wants' constitutes an additional option for patients with hepatocellular carcinomas and cirrhosis.”

“The risk-benefit ratio in these instances should be evaluated on a case-by-case basis.”

Transplant 2005: 80(7): 897-902
31 October 2005

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