title: Transarterial Embolization and Percutaneous Ethanol Injection as an Effective Bridge Therapy before Liver Transplantation for Hepatitis C-Related Hepatocellular Carcinoma.
abstract: Background. Transarterial chemoembolization alone or in association with radiofrequency ablation is an effective bridging strategy for patients with hepatocellular carcinoma awaiting for a liver transplant. However, cost of this therapy may limit its utilization. This study was designed to evaluate the outcomes of a protocol involving transarterial embolization, percutaneous ethanol injection, or both methods for bridging hepatocellular carcinomas prior to liver transplantation. Methods. Retrospective review of all consecutive adult patients who underwent a first liver transplant as a treatment to hepatitis C-related hepatocellular carcinoma at our institution between 2002 and 2012. Primary endpoint was patient survival. Secondary endpoint was complete tumor necrosis. Results. Forty patients were analyzed, age 58 ± 7 years. There were 23 males (57.5%). Thirty-six (90%) out of the total 40 patients were within Milan criteria. Complete necrosis was achieved in 19 patients (47.5%). One-, 3-, and 5-year patient survival were, respectively, 87.5%, 75%, and 69.4%. Univariate analysis did not reveal any variable to impact on overall patient survival. Conclusions. Transarterial embolization, ethanol injection, or the association of both methods followed by liver transplantation comprises effective treatment strategy for hepatitis C-related hepatocellular carcinoma. This strategy should be adopted whenever transarterial chemoembolization and/or radiofrequency ablation are not available options.
authors.affiliation: Liver and Pancreas Transplant and Hepatobiliary Surgery Unit, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Sixth Floor, Room 600, Rua Ramiro Barcelos 2350, 90035-903 Porto Alegre, RS, Brazil.
authors.forename: Marcio F
authors.initials: MF
authors.lastname: Chedid
authors.affiliation: Interventional Radiology Unit, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
authors.forename: Leandro A
authors.initials: LA
authors.lastname: Scaffaro
authors.affiliation: Liver and Pancreas Transplant and Hepatobiliary Surgery Unit, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Sixth Floor, Room 600, Rua Ramiro Barcelos 2350, 90035-903 Porto Alegre, RS, Brazil.
authors.forename: Aljamir D
authors.initials: AD
authors.lastname: Chedid
authors.affiliation: Interventional Radiology Unit, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
authors.forename: Antonio C
authors.initials: AC
authors.lastname: Maciel
authors.affiliation: Division of Pathology, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
authors.forename: Carlos Thadeu S
authors.initials: CT
authors.lastname: Cerski
authors.affiliation: Liver and Pancreas Transplant and Hepatobiliary Surgery Unit, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Sixth Floor, Room 600, Rua Ramiro Barcelos 2350, 90035-903 Porto Alegre, RS, Brazil.
authors.forename: Matheus J
authors.initials: MJ
authors.lastname: Reis
authors.affiliation: Liver and Pancreas Transplant and Hepatobiliary Surgery Unit, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Sixth Floor, Room 600, Rua Ramiro Barcelos 2350, 90035-903 Porto Alegre, RS, Brazil.
authors.forename: Tomaz J M
authors.initials: TJ
authors.lastname: Grezzana-Filho
authors.affiliation: Division of Gastroenterology and Hepatology, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
authors.forename: Alexandre
authors.initials: A
authors.lastname: de Araujo
authors.affiliation: Liver and Pancreas Transplant and Hepatobiliary Surgery Unit, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Sixth Floor, Room 600, Rua Ramiro Barcelos 2350, 90035-903 Porto Alegre, RS, Brazil.
authors.forename: Ian
authors.initials: I
authors.lastname: Leipnitz
authors.affiliation: Liver and Pancreas Transplant and Hepatobiliary Surgery Unit, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Sixth Floor, Room 600, Rua Ramiro Barcelos 2350, 90035-903 Porto Alegre, RS, Brazil.
authors.forename: Cleber D P
authors.initials: CD
authors.lastname: Kruel
authors.affiliation: Division of Gastroenterology and Hepatology, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
authors.forename: Mario R
authors.initials: MR
authors.lastname: Alvares-da-Silva
authors.affiliation: Liver and Pancreas Transplant and Hepatobiliary Surgery Unit, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Sixth Floor, Room 600, Rua Ramiro Barcelos 2350, 90035-903 Porto Alegre, RS, Brazil.
authors.forename: Cleber R P
authors.initials: CR
authors.lastname: Kruel
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