title: Multivisceral transplantation for the treatment of intra-abdominal tumors.
abstract: BACKGROUND
  Some intra-abdominal or retroperitoneal tumors such as low-grade slow-growing malignancies may seem unresectable due to major vessel encasement or presence of intra-abdominal dissemination, but the slow growth rate and to some extent long life expectancy of the patients urge us to find some strategies to cure the patients or at least achieve tumor remission or symptom palliation. En bloc resection, followed by multivisceral or liver-sparing "modified" multivisceral transplantation has recently been used for treatment of these patients.
  
  
  RESULTS
  Between May 2010 and October 2012, 3 multivisceral and 3 modified multivisceral transplantations were performed in 6 patients (aged 14 to 55 years; mean, 32 years) with some slow growing intra-abdominal malignancies (2 neuroendocrine tumors, 2 gastrointestinal stromal tumors, 1 desmoid tumor, and 1 low-grade sarcoma). All patients survived the procedure. One patient died of pancytopenia 2 months after transplantation and another died with pulmonary emboli at 4 months. The remaining 4 patients are alive without any evidence of disease recurrence.
  
  
  CONCLUSIONS
  Although large intra-abdominal desmoid tumors, well-differentiated neuroendocrine tumors, and gastrointestinal stromal tumors are slow growing, they tend to invade locally, especially to the mesenteric root and/or celiac axis and other abdominal viscera. Complete resection followed by multivisceral transplantation could be a therapeutic option for these advanced tumors.
authors: Department of Surgery, Namazi Hospital, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
authors: S
authors: S
authors: Nikeghbalian
authors: M
authors: M
authors: Aliakbarian
authors: A
authors: A
authors: Shamsaeefar
authors: K
authors: K
authors: Kazemi
authors: A
authors: A
authors: Bahreini
authors: S A
authors: SA
authors: Malekhosseini
mesh_terms: D000008:Abdominal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D002454:Cell Differentiation; D005260:Female; D018222:Desmoid Tumors / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D046152:Gastrointestinal Stromal Tumors / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D018358:Neuroendocrine Tumors / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016377:Organ Transplantation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D010166:Palliative Care; D012509:Sarcoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D047368:Tumor Burden