ORTHOTOPIC LIVER-TRANSPLANTATION IN PRIMARY LIVER-TUMORS

Among 283 orthotopic liver transplantations made during the last 6 yea rs at our institution, 22 (7.77%) were done on 19 patients with unrese ctable hepatic malignant tumors [hepatocellular carcinoma (17), angios arcoma (1), and cholangiocarcinoma (1)]. None of them showed extrahepa tic invasion, and only one had lymph node involvement. Cyclosporin A, corticosteroids, and azathioprine were administered for 3 months after the procedure, and maintenance therapy involved the first two drugs. Acute rejection rate and hospital stay were not significantly differen t compared with non-tumoral grafted patients. Three patients were retr ansplanted, one with uncontrolled acute rejection and two with chronic rejection. Intraoperative mortality was zero. Eight patients (42.1%) were alive at a mean follow-up of 31 months (range, 6-74). Four 22.2%) died with tumor recurrence, three of sepsis, two of respiratory insuf ficiency, one of hepatitis recurrence with cirrhosis, and one of prima ry lung neoplasia. If adequately selected, primary liver tumor patient s may benefit from liver transplantation. Future research with adjuvan t therapies will improve the results.