活体供肝肝移植治疗肝内胆管癌。巴西的初步经验。
LIVING DONOR LIVER TRANSPLANT FOR INTRAHEPATIC CHOLANGIOCARCINOMA. AN INITIAL BRAZILIAN EXPERIENCE.
作者信息
Fernandes Eduardo de Souza Martins, Mello Felipe Pedreira Tavares de, Andrade Ronaldo de Oliveira, Girão Camila Liberato, Cesar Camila, Pimentel Leandro Savattone, Coelho Henrique Sergio Moraes, Basto Samanta Teixeira, Siqueira Munique, Brito Anderson, Sousa Claudia Cristina Tavares DE, Genzini Tercio, Torres Orlando Jorge Martins
机构信息
São Lucas Hospital, Departament of Gastrointestinal and Liver Transplant Surgery - Rio de Janeiro (RJ), Brazil.
São Lucas Hospital, Department of Gastroenterology and Hepatology - Rio de Janeiro (RJ), Brazil.
出版信息
Arq Bras Cir Dig. 2024 Dec 2;37:e1839. doi: 10.1590/0102-6720202400045e1839. eCollection 2024.
BACKGROUND
Intrahepatic cholangiocarcinoma (iCCA) was considered a contraindication for liver transplantation. However, recent studies have shown that highly selected cases of patients with a good response to neoadjuvant therapy may achieve acceptable survival rates when following liver transplantation.
AIMS
To present two cases of patients with iCCA, without extrahepatic disease, who underwent living donor liver transplantation after receiving neoadjuvant chemotherapy.
METHODS
Two cases of patients with histopathological diagnosis of locally advanced iCCA, ineligible for resection and without evidence of extrahepatic disease, are presented.
RESULTS
These patients underwent at least nine sessions of neoadjuvant chemotherapy, including Gemcitabine and Cisplatin, with or without the addition of immunobiological agents, resulting in a radiological tumor response. They subsequently underwent living donor liver transplantation. The average follow-up time was 15 months, with no clinical or radiological signs of disease.
CONCLUSIONS
In well-selected patients without extrahepatic disease, living donor liver transplantation represents a potential therapeutic option for iCCA.
背景
肝内胆管癌（iCCA）曾被视为肝移植的禁忌证。然而，近期研究表明，经严格筛选且对新辅助治疗反应良好的患者，肝移植后可能获得可接受的生存率。
目的
介绍两例无肝外病变的iCCA患者，他们在接受新辅助化疗后接受了活体肝移植。
方法
呈现两例经组织病理学诊断为局部晚期iCCA、无法切除且无肝外病变证据的患者。
结果
这些患者接受了至少九个疗程的新辅助化疗，包括吉西他滨和顺铂，加用或未加用免疫生物制剂，影像学检查显示肿瘤有反应。随后他们接受了活体肝移植。平均随访时间为15个月，无疾病的临床或影像学迹象。
结论
对于精心挑选的无肝外病变患者，活体肝移植是iCCA的一种潜在治疗选择。
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