Long-term survival after liver transplant for recurrent hepatocellular carcinoma with bile duct tumor thrombus: case report.
Long-term survival after liver transplant for recurrent hepatocellular carcinoma with bile duct tumor thrombus: case report.
复制标题
复发性肝细胞癌合并胆管癌栓肝移植术后的长期生存：病例报告。
DOI：
10.6002/ect.2012.0022
复制
发表时间：
2012
期刊：
影响因子：
--
通讯作者：
Jie Wang
中科院分区：
文献类型：
--
作者：
Chao Liu;Jie Wang
目标
肝细胞癌合并胆管癌栓被认为是一种侵袭性恶性肿瘤，其肝移植预后尚不清楚。
材料和方法
本院收治一位42岁男性复发性肝细胞癌患者，有手术切除史，有10天尿黄及皮肤瘙痒的病史。右叶3个，直径均为2 cm。胆总管上部有肿块，肝内胆管扩张。血清甲胎蛋白为2476μg/L，总胆红素为327μ/L，直接胆红素为261μ/L，丙氨酸氨基转移酶为714U/L，无门静脉主干血栓及肝外转移。由于肝功能不佳，他被列入肝脏移植手术名单。在等待期间(30d)，他接受了9次血浆置换以降低血清胆红素水平。他用一位已故捐赠者的移植物进行了原位肝移植。肝移植后，他接受了5个周期的化疗，方案为奥沙利铂和5-氟尿嘧啶。
结果
这位患者已存活超过82个月，未见肝细胞癌复发，目前情况良好。
结论
在米兰标准范围内，肝移植对合并胆管癌栓的肝细胞癌患者可能有良好的治疗效果。
OBJECTIVES
Hepatocellular carcinoma with bile duct tumor thrombus is considered an aggressive malignancy, and the prognosis of liver transplant for it remains obscure.
MATERIALS AND METHODS
A 42-year-old man with recurrent hepatocellular carcinoma and a history of surgical resection was admitted to our hospital with a 10-day history of yellowish urine and itchy skin. There were 3 lesions in the right lobe with the diameter of 2 cm each. A mass was found in the upper part of common bile duct, and the intrahepatic bile duct was dilated. His serum alpha-fetoprotein level was 2476 μg/L, total bilirubin level was 327 μmol/L, direct bilirubin level was 261 μmol/L, and alanine aminotransferase was 714 U/L. There was no main portal vein thrombus or extrahepatic metastases. Because of his poor liver function, he was listed for a liver transplant. During the wait (30 d), he underwent 9 episodes of plasmapheresis to decrease the serum level of bilirubin. He had an orthotopic liver transplant with the graft from a deceased donor. After the liver transplant, he received 5 cycles of chemotherapy with the regimen of oxaliplatin and 5-fluorouracil.
RESULTS
This patient has survived without recurrence of hepatocellular carcinoma for more than 82 months and remains in good condition.
CONCLUSIONS
Liver transplant may have a favorable result for hepatocellular carcinoma patient with a bile duct tumor thrombus, within the Milan criteria.
影响因子：
9
作者：
Fong, YM;Sun, RL;Blumgart, LH
通讯作者：
Blumgart, LH