title: Orthotopic liver or multivisceral transplantation as treatment of metastatic neuroendocrine tumors.
abstract: Liver transplantation can be a therapeutic option for individual patients with neuroendocrine tumors metastatic only to the liver. In this consecutive series of 15 patients (5 multivisceral and 10 orthotopic liver transplantations) with well-differentiated carcinoids, or endocrine pancreatic tumors, we allowed higher proliferation rate (Ki67 <10%), large tumor burden, and higher age than previous studies. Liver transplantation offered good relief of symptoms, long disease-free intervals, and potential cure in individual patients. The survival of grafts and patients compared well with transplantation for benign disease. The overall 5-year survival was 90%. The recurrence-free survival of both multivisceral and liver transplantation related to the time after transplantation (about 20% at 5 years) despite inclusion of patients with higher risk. In conclusion, the critical prognosticators for long-term outcome still remain to be defined. The experience with multivisceral transplantation for patients with endocrine tumors of the pancreatic head is still limited.
authors.affiliation: Sahlgrenska Transplant Institute, Sahlgrenska Academy, University of Göteborg, Göteborg, Sweden.
authors.forename: Michael
authors.initials: M
authors.lastname: Olausson
authors.forename: Styrbjörn
authors.initials: S
authors.lastname: Friman
authors.forename: Gustaf
authors.initials: G
authors.lastname: Herlenius
authors.forename: Christian
authors.initials: C
authors.lastname: Cahlin
authors.forename: Ola
authors.initials: O
authors.lastname: Nilsson
authors.forename: Svante
authors.initials: S
authors.lastname: Jansson
authors.forename: Bo
authors.initials: B
authors.lastname: Wängberg
authors.forename: Håkan
authors.initials: H
authors.lastname: Ahlman
mesh_terms: D000328:Adult; D004386:Duodenum / Q000637:transplantation; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D018358:Neuroendocrine Tumors / Q000556:secondary* / Q000601:surgery*; D016377:Organ Transplantation; D016035:Pancreas Transplantation; D010190:Pancreatic Neoplasms / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies; D013270:Stomach / Q000637:transplantation; D015996:Survival Rate; D016896:Treatment Outcome