Efficacy of loco-regional treatment for Hepatocellular Carcinoma Prior to Living Donor Liver Transplantation

Hesham Abd El-Aty Fadl;

Abstract


This study was conducted to evaluate the outcome Of HCC patient after liver transplantation who received pre-transplant loco-regional treatment (radiofrequency ablation and/or chemoembolization treatment).

To fulfill the aim of our study all patient suffered from hepatocellular carcinoma and had locoregonal therapy then underwent liver transplantation at Ain shams center for organ transplantation (ASCOT) between march 2011 till October 2014 were enrolled in this study.
All studied patients were subjected to: (1) A detailed history taking from each patient, (2) Initial hepatopathy, and (3) Previous history of encephalopathy, or subacute bacterial peritonitis, or ascites. (4) Locoregional therapy (5) clinical general and abdominal examination, (6) investigations including complete blood count, liver function tests, kidney function tests, etiology of the underlying liver disease (viral, autoimmune, etc ), and Alpha fetoprotein (AFP) level, (7) Child Pugh score, MELD score. (8) Ultrasound and duplex, (9) Waiting time for liver transplantation, (10) Abdominal Triphasic spiral CT or MRI abdomen before and after locoregional therapy, (11) histopathological evaluation of the explants.


The age of patients ranged from 18 - 65 years with a mean age of (52.04±7.04) years. Regarding sex distribution 27 (93.1%) patients were males and 2 (6.9%) patients were females.
Hepatitis C virus is an important cause of hepatocellular carcinoma in the Egyptian population. (79.3%) of included patients were infected with hepatitis C virus.
Majority of included patient (41.38%, 34.48%) were Child Pough score B,C respectively , and mean of MELD was (8.28±1.89).

According to distribution of focal lesions in liver, the majority of patient’s lesion site was (65.5%) in right lobe and (31%) in both lobes and one patient had focal lesions in left lobe.

At time of diagnosis there were 20 (68.97%) patients initially within Milan and 4 (13.8%) patients beyond Milan but meet UCSF criteria and 5 (17.2%) patients exceeding UCSF criteria. All of them received locoregonal therapy, 10 (34.48%) patients had only RFA , 11(37.93%) patients had only TACE , 7(24.23%) patients had combination TACE and RFA ,one patient(3.45%) had microwave ablation. follow up triphasic spiral abdominal CT after last intervention showed that


Other data

Title Efficacy of loco-regional treatment for Hepatocellular Carcinoma Prior to Living Donor Liver Transplantation
Other Titles دراسه فاعليه العلاج الموضعي لسرطان الكبد الاولي قبل زراعه الكبد من متبرع حي
Authors Hesham Abd El-Aty Fadl
Issue Date 2015

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