Successful embolization of hepatocelluar carcinoma with yttrium-90 glass microspheres prior to liver transplantation.
We report a case of a patient with end-stage liver disease secondary to hepatitis C, complicated by a large hepatocellular carcinoma. Because of the size of the tumor exceeded the Milan criteria, he was not a candidate for liver transplantation. However, after two treatments with yttrium-90 glass microsphere infusions, the tumor became smaller and the patient's alpha-fetoprotein level dropped to normal range. He was listed for transplantation and subsequently received a deceased donor liver transplant. Two years after his transplantation, he remains tumor free and has normal alpha-fetoprotein levels. This is the first reported case in the literature of using yttrium-90 microspheres as a bridge to liver transplantation in a patient with a large hepatocellular carcinoma. This therapy should be considered in patients with cirrhosis and large hepatocellular carcinomas exceeding current size criterion, who would otherwise be good candidates for transplantation.
Kim
Dean Y
DY
Division of Transplant and Hepatobiliary Surgery, Henry Ford Transplant Institute, Henry Ford Hospital, 2799 West Grand Boulevard, Detroit, MI 48202, USA. dkim3@hfhs.org
Kwon
David S
DS
Salem
Riad
R
Ma
Chan K
CK
Abouljoud
Marwan S
MS
D006528:Carcinoma, Hepatocellular / Q000601:surgery / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery / Q000628:therapy*; D016031:Liver Transplantation; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D015021:Yttrium Radioisotopes / Q000627:therapeutic use*
D015021:Yttrium Radioisotopes