Cho Chan Woo, Lee Nuri, Choi Gyu-Seong, Kim Jong Man, Kwon Choon Hyuck David, Joh Jae-Won
Department of Surgery, Yeungnam University College of Medicine, Daegu, Korea.
Department of Surgery, Pusan National University Hospital, Busan, Korea.
Ann Surg Treat Res. 2018 Apr;94(4):216-218. doi: 10.4174/astr.2018.94.4.216. Epub 2018 Mar 26.
Clinical outcomes of living donor liver transplantation (LDLT) for hepatocellular carcinoma (HCC) in patients with multiple myeloma (MM) have not been established in terms of HCC recurrence and MM deterioration after LDLT. A 51-year-old man with chronic hepatitis B was diagnosed with HCC and MM. Since the patient also had decompensated liver cirrhosis (LC), he underwent LDLT prior to autologous peripheral blood stem cell transplantation (PBSCT) to prevent fulminant hepatitis due to HBV reactivation. The patient received Epstein-Barr virus prophylaxis and a triple immunosuppressive regimen of tacrolimus, everolimus, and steroid after LDLT. Autologous PBSCT was performed 7 months after LDLT. He showed a complete response to treatment of MM without post-LT complications or HCC recurrence. In conclusion, LDLT could be adapted for treatment of MM patients with combined HCC and decompensated LC because it is an effective strategy of preventing HBV reactivation and HCC recurrence after induction therapy of MM.
关于多发性骨髓瘤（MM）患者接受活体供肝肝移植（LDLT）治疗肝细胞癌（HCC）后的临床结局，在LDLT后HCC复发和MM病情恶化方面尚未明确。一名51岁的慢性乙型肝炎男性被诊断为HCC和MM。由于该患者还患有失代偿期肝硬化（LC），他在自体外周血干细胞移植（PBSCT）之前接受了LDLT，以预防因HBV再激活导致的暴发性肝炎。患者在LDLT后接受了爱泼斯坦-巴尔病毒预防措施以及他克莫司、依维莫司和类固醇的三联免疫抑制方案。LDLT后7个月进行了自体PBSCT。他对MM治疗显示出完全缓解，且无LT后并发症或HCC复发。总之，LDLT可适用于合并HCC和失代偿期LC的MM患者，因为它是预防MM诱导治疗后HBV再激活和HCC复发的有效策略。
