Mont Alverne Pierre Alessandra Maria, Veras Camila Monteiro, Esmeraldo Ticiana Mota, Schwermann Maximilian Pinho, Studart E Neves Marina Seixas, Bastos Pinho José Eudes, Canito Brasil Ivelise Regina
Liver Transplantation Division, Fortaleza General Hospital, Fortaleza, Ceara, Brazil.
Liver Transplantation Division, Fortaleza General Hospital, Fortaleza, Ceara, Brazil.
Transplant Proc. 2019 Dec;51(10):3355-3359. doi: 10.1016/j.transproceed.2019.09.001. Epub 2019 Oct 25.
Liver transplantation has become an effective treatment for selected patients with hepatocellular carcinoma with excellent outcomes. More recent reports have described improved outcomes in liver transplantation in a subset of patients with other malignancies like hilar cholangiocarcinoma, unresectable hepatic epithelioid hemangioendothelioma and hepatic metastasis from neuroendocrine tumors. However, hepatic angiosarcoma remains an absolute contraindication to liver transplantation because of the poor outcome.
The present study aims to describe liver transplantation for non-hepatocellular carcinoma malignancy.
A retrospective analysis of patients and review of the literature was performed.
A total of 5 patients with non-hepatocellular carcinoma malignancy on explants histopathologic findings were identified. They presented hepatic epithelioid hemangioendothelioma (1), neuroendocrine tumor (1), angiosarcoma (1) and cholangiocarcinoma (2). The mean length of follow-up was 22.8 ± 37.67 (range, 2-90 months). Of 5 patients evaluated, 3 patients remain with stable graft function.
Future investigations are necessary to redefine the indications of liver transplantations to treat non-hepatocellular carcinoma malignancy and its limitation.
肝移植已成为治疗特定肝细胞癌患者的有效方法,疗效显著。最近的报告描述了在肝移植治疗其他恶性肿瘤患者亚组中(如肝门胆管癌、不可切除的肝上皮样血管内皮瘤和神经内分泌肿瘤肝转移)的疗效改善。然而,由于预后不佳,肝血管肉瘤仍然是肝移植的绝对禁忌证。
本研究旨在描述非肝细胞癌恶性肿瘤的肝移植情况。
对患者进行回顾性分析并复习文献。
在外植体组织病理学检查中,共鉴定出5例非肝细胞癌恶性肿瘤患者。他们分别患有肝上皮样血管内皮瘤(1例)、神经内分泌肿瘤(1例)、血管肉瘤(1例)和胆管癌(2例)。平均随访时间为22.8 ± 37.67(范围2 - 90个月)。在评估的5例患者中,3例患者的移植肝功能保持稳定。
未来有必要进行研究,以重新界定肝移植治疗非肝细胞癌恶性肿瘤的适应证及其局限性。