Liver transplantation after radioembolization in a patient with unresectable HCC.
BACKGROUND
A 58-year-old white man who was being followed by his hepatologist for nonalcoholic steatohepatitis-related liver cirrhosis and portal hypertension and who had been found to have a biopsy-proven hepatocellular carcinoma (HCC) on routine screening, self-referred to our center for a second opinion on the management of his HCC.


METHODS
Laboratory investigations, CT scan of the abdomen and chest, bone scan and technetium macroaggregated albumin scan.


METHODS
The patient had unresectable HCC.


RESULTS
The patient underwent two treatments with Yttrium-90 glass microspheres, which were performed as outpatient procedures 1 month and 3 months after diagnosis. He underwent orthotopic liver transplantation (OLT) 1 year after the initial diagnosis of HCC. The post-OLT immunoregimen included OKT3 plus rituximab and high-dose steroids. On discharge from hospital he was on immunosuppressive treatment with tacrolimus. He had de novo autoimmune hepatitis 6 months post-OLT, which was treated with a short course of low-dose steroids and addition of mycophenolate mofetil.
Luna
Laura E Moreno
LE
Department of Medicine, Universidad de Guadalajara, Guadalajara, México.
Kwo
Paul Y
PY
Roberts
Lewis R
LR
Mettler
Teresa A
TA
Gansen
Denise N
DN
Andrews
James C
JC
Wiseman
Gregory A
GA
Misra
Vijay Laxmi
VL
D006528:Carcinoma, Hepatocellular / Q000532:radiotherapy* / Q000601:surgery*; D016461:Chemoembolization, Therapeutic; D003131:Combined Modality Therapy; D006801:Humans; D008113:Liver Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D015021:Yttrium Radioisotopes / Q000627:therapeutic use
D015021:Yttrium Radioisotopes