ORTHOTOPIC LIVER-TRANSPLANTATION FOR BENIGN HEPATIC NEOPLASMS

Objective: To evaluate the frequency and outcome of liver transplantat ion for symptomatic, unresectable, benign hepatic neoplasms. Design: R etrospective study. Setting: Presbyterian University Hospital, a terti ary care referral center for liver transplantation affiliated with the University of Pittsburgh (Pa). Patients: All 3239 liver transplant re cipients at the University of Pittsburgh from January 1981 until Janua ry 1993. Results: Twelve (0.37%) of 3239 patients required liver trans plantation for benign, highly symptomatic hepatic neoplasms that were unresectable. Origins included adenoma (n=6), mesenchymal hamartoma (n =2), massive hepatic lymphangiomatosis (n=1), hilar fibrous angiodyspl asia (n=1), focal nodular hyperplasia (n=1),and hemangioma (n=1). Ther e were three perioperative deaths and two late deaths at 56 and 84 mon ths. The remaining patients are alive. with follow-up ranging from 36 to 145 months. Median survival for the nine patients who survived the perioperative period is 88 months. The early deaths were attributable to hemorrhagic complications (n=2) and necrotizing pancreatitis (n=1). The two late deaths were due to disseminated aspergillosis and hepati tis-associated cirrhosis. Conclusion: Patients with severe symptoms fr om benign hepatic neoplasms that am not resectable can be treated by t otal hepatectomy and orthotopic liver transplantation, with the expect ation of good long-term results.