title: Isolated hepatic perfusion as a treatment for liver metastases of uveal melanoma.
abstract: Isolated hepatic perfusion (IHP) is a procedure where the liver is surgically isolated and perfused with a high concentration of the chemotherapeutic agent melphalan. Briefly, the procedure starts with the setup of a percutaneous veno-venous bypass from the femoral vein to the external jugular vein. Via a laparotomy, catheters are then inserted into the proper hepatic artery and the caval vein. The portal vein and the caval vein, both supra- and infrahepatically, are then clamped. The arterial and venous catheters are connected to a heart lung machine and the liver is perfused with melphalan (1 mg/kg body weight) for 60 min. This way it is possible to locally perfuse the liver with a high dose of a chemotherapeutic agent, without leakage to the systemic circulation. In previous studies including patients with isolated liver metastases of uveal melanoma, an overall response rate of 33-100% and a median survival between 9 and 13 months, have been reported. The aim of this protocol is to give a clear description of how to perform the procedure and to discuss IHP as a treatment option for liver metastases of uveal melanoma.
authors: Department of Surgery, Institute of Clinical Sciences; Sahlgrenska University Hospital, Sahlgrenska Academy at the University of Gothenburg.
authors: Ilan
authors: I
authors: Ben-Shabat
authors: Department of Thoracic Surgery, Institute of Clinical Sciences; Sahlgrenska University Hospital, Sahlgrenska Academy at the University of Gothenburg.
authors: Christoffer
authors: C
authors: Hansson
authors: Transplant Institute, Institute of Clinical Sciences; Sahlgrenska University Hospital, Sahlgrenska Academy at the University of Gothenburg.
authors: Malin
authors: M
authors: Sternby Eilard
authors: Transplant Institute, Institute of Clinical Sciences; Sahlgrenska University Hospital, Sahlgrenska Academy at the University of Gothenburg.
authors: Christian
authors: C
authors: Cahlin
authors: Transplant Institute, Institute of Clinical Sciences; Sahlgrenska University Hospital, Sahlgrenska Academy at the University of Gothenburg.
authors: Magnus
authors: M
authors: Rizell
authors: Transplant Institute, Institute of Clinical Sciences; Sahlgrenska University Hospital, Sahlgrenska Academy at the University of Gothenburg.
authors: Per
authors: P
authors: Lindnér
authors: Department of Surgery, Institute of Clinical Sciences; Sahlgrenska University Hospital, Sahlgrenska Academy at the University of Gothenburg.
authors: Jan
authors: J
authors: Mattsson
authors: Department of Surgery, Institute of Clinical Sciences; Sahlgrenska University Hospital, Sahlgrenska Academy at the University of Gothenburg; roger.olofsson@surgery.gu.se.
authors: Roger
authors: R
authors: Olofsson Bagge
mesh_terms: D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000379:methods*; D005112:Extracorporeal Circulation; D006355:Heart-Lung Machine; D006499:Hepatic Artery; D006801:Humans; D008113:Liver Neoplasms / Q000098:blood supply / Q000188:drug therapy* / Q000556:secondary*; D008545:Melanoma / Q000188:drug therapy* / Q000473:pathology*; D008558:Melphalan / Q000008:administration & dosage; D011169:Portal Vein; D014604:Uveal Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D062666:Vascular Access Devices; D000098943:Uveal Melanoma
chemical_list: D018906:Antineoplastic Agents, Alkylating; D008558:Melphalan
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