title: Living donor liver transplantation to a survivor of liver resection for hepatocellular carcinoma with major portal vein invasion.
abstract: We present a case of living donor liver transplantation to a 3-year disease-free survivor of liver resection for hepatocellular carcinoma (HCC) with major portal vein invasion. A 48-year-old man had HCC in the right lobe with a portal venous tumor thrombus extending into the left portal vein. An extended right lobectomy with thrombectomy was performed to remove the thrombus. Three years after liver resection, the patient experienced liver failure, with massive ascites and jaundice due to the formation of a thrombus in the main and left portal veins. During the 3 years after liver resection, no metastasis or recurrence of HCC had been detected, and tumor markers had been within normal ranges. The portal venous thrombus did not show any arterial enhancement under contrast-enhanced computed tomography, suggesting that the co-existence of any HCC component in the portal venous thrombus may have been negative. Based on these findings, living donor liver transplantation was performed using a right lobe graft from the patient's son. The patient is alive at 87 months after the transplantation, with no evidence of HCC recurrence.
authors.affiliation: Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan. sada@md.okayama-u.ac.jp
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sadamori
authors.forename: Takahito
authors.initials: T
authors.lastname: Yagi
authors.forename: Susumu
authors.initials: S
authors.lastname: Shinoura
authors.forename: Yuzo
authors.initials: Y
authors.lastname: Umeda
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Yoshida
authors.forename: Daisuke
authors.initials: D
authors.lastname: Sato
authors.forename: Daisuke
authors.initials: D
authors.lastname: Nobuoka
authors.forename: Masashi
authors.initials: M
authors.lastname: Utsumi
authors.forename: Toshiyoshi
authors.initials: T
authors.lastname: Fujiwara
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011169:Portal Vein / Q000000981:diagnostic imaging / Q000473:pathology; D017741:Survivors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome