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Liver transplantation after radioembolization in a patient with unresectable HCC

Nature Reviews Gastroenterology & Hepatology volume 6, pages 679–683 (2009)Cite this article

Abstract

Background. A 58-year-old white man who was being followed by his hepatologist for nonalcoholic steatohepatitis-related liver cirrhosis and portal hypertension and who had been found to have a biopsy-proven hepatocellular carcinoma (HCC) on routine screening, self-referred to our center for a second opinion on the management of his HCC.

Investigations. Laboratory investigations, CT scan of the abdomen and chest, bone scan and technetium macroaggregated albumin scan.

Diagnosis. The patient had unresectable HCC.

Management. The patient underwent two treatments with Yttrium-90 glass microspheres, which were performed as outpatient procedures 1 month and 3 months after diagnosis. He underwent orthotopic liver transplantation (OLT) 1 year after the initial diagnosis of HCC. The post-OLT immunoregimen included OKT3 plus rituximab and high-dose steroids. On discharge from hospital he was on immunosuppressive treatment with tacrolimus. He had de novo autoimmune hepatitis 6 months post-OLT, which was treated with a short course of low-dose steroids and addition of mycophenolate mofetil.

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Acknowledgements

Lewis R. Roberts is supported by Mayo Clinic and Mayo Cancer Center, NIH Grants CA82862 and CA100882, an Industry Research Scholar Award from the Foundation for Digestive Health and Nutrition, a Harold Amos Medical Faculty Development Award from The Robert Wood Johnson Foundation, a generous gift from The Richard M. Schulze Family Foundation and the Miles and Shirley Fiterman Center for Digestive Diseases at the Mayo Clinic, Rochester, MN. The authors thank Vicki Campion for secretarial assistance.

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Authors and Affiliations

  1. Department of Medicine, Universidad de Guadalajara, Guadalajara, México

    Laura E. Moreno Luna

  2. Department of Medicine, Miles and Shirley Fiterman Center for Digestive Diseases, Rochester, MN, USA

    Lewis R. Roberts & Teresa A. Mettler

  3. Department of Radiology Mayo Clinic, Rochester, MN, USA

    Denise N. Gansen, James C. Andrews & Gregory A. Wiseman

  4. Department of Medicine, Division of Gastroenterology/Hepatology, Indiana University School of Medicine, Clarian/IU Digestive Diseases Center, Indianapolis, IN, USA

    Paul Y. Kwo & Vijay Laxmi Misra

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Correspondence to Vijay Laxmi Misra.

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Competing interests

Lewis R. Roberts reports receiving consulting fees from Isis Pharmaceuticals and Rosetta Genomics and grant support from Wako Diagnostics, MDS Nordion, and Bristol-Myers Squibb.

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Luna, L., Kwo, P., Roberts, L. et al. Liver transplantation after radioembolization in a patient with unresectable HCC. Nat Rev Gastroenterol Hepatol 6, 679–683 (2009). https://doi.org/10.1038/nrgastro.2009.165

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