title: Living donor liver transplantation followed by total gastrectomy--a two-stage planed operative strategy for early gastric cancer concomitant with decompensated liver cirrhosis.
abstract: OBJECTIVE
  With the recent popularization of living donor liver transplantation (LDLT), providing treatment for comorbidities in LDLT recipients has become important. We report the first case of a patient who was successfully treated with LDLT followed by total gastrectomy for early gastric cancer concomitant with decompensated liver cirrhosis.
  
  
  METHODS
  A 64-year-old female was admitted for the treatment of severe liver cirrhosis. The patient's preoperative liver function was evaluated as Child-Pugh classification grade C. Upper gastrointestinal endoscopy revealed early gastric cancer. We first performed LDLT to improve her liver function and coagulopathy. Nineteen days after the LDLT, we performed total gastrectomy.
  
  
  RESULTS
  The patient's postoperative course was uneventful and she left our hospital on the 18th day after gastrectomy. The final pathological diagnosis of gastric cancer was Stage IA.
  
  
  CONCLUSIONS
  Aggressive and adequate surgical strategy including LDLT is effective as curative treatment in patients with controllable malignancy concomitant with severe liver dysfunction.
authors: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan.
authors: Sho
authors: S
authors: Nishimura
authors: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan.
authors: Hiroshi
authors: H
authors: Saeki
authors: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan.
authors: Toru
authors: T
authors: Ikegami
authors: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan.
authors: Koji
authors: K
authors: Ando
authors: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan.
authors: Yo-Ichi
authors: Y
authors: Yamashita
authors: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan.
authors: Eiji
authors: E
authors: Oki
authors: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan.
authors: Tomoharu
authors: T
authors: Yoshizumi
authors: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan.
authors: Masaru
authors: M
authors: Morita
authors: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan.
authors: Ken
authors: K
authors: Shirabe
authors: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan maehara@surg2.med.kyushu-u.ac.jp.
authors: Yoshihiko
authors: Y
authors: Maehara
mesh_terms: D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D008103:Liver Cirrhosis / Q000601:surgery*; D016031:Liver Transplantation; D019520:Living Donors; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000601:surgery*
keywords: Early gastric cancer; coagulopathy; gastrectomy; liver transplantation; primary biliary cirrhosis