Liver transplantation for hepatic tumors

Abstract

The incidence of hepatocellular carcinoma is increasing within the population of Western Europe and North America. Improved diagnostic means and improved general medical care account for the more frequent detection of hepatic malignomas rather than the incidence of hepatic cirrhosis and chronic active hepatitis [2]. Surgical treatment regularly precedes any alternative therapy. Early detection of the hepatic lesion has frequently resulted in a successful hepatic resection when the tumor was found to be confined to an anatomical lobe of the liver. In addition, in cases of irresectability, intraarterial or systemic infusion of chemotherapy or embolization could be started by the same laparotomy, inserting a pump infusion system selectively into the hepatic artery [1]. Trials on the effect of tumor treatment by local application are still to be performed. However, it will become an increasingly more important approach since reports on the ultimate mode of treatment for irresectable hepatic malignancies by liver replacement have been discouraging in the long-term prognosis (Aigner et al. 1984, personal communication). Various types of hepatic malignomas have been transplanted in the past, all of which spontaneously have a different prognosis which makes comparison of survival rates and determination of prognosis very difficult (Table 1).