Page 261 - ebook HCC

PROGRAMME AND ABSTRACTSAND ABSTRACTS
EASL HCC SUMMITHCC SUMMIT
GENEV
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258 PROGRAMME GENEVA, SWITZERLANDA, SWITZERLAND EASL 259
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FEBRUARY 13 - 16, 2014Y 13 - 16, 2014
FEBRUAR
Poster Board Number C41 Poster Board Number C42
ONE YEAR DISEASE-FREE FOLLOW UP AFTER INTRAOPERATIVE BLOOD SALVAGE DURING
ORTHOTOPIC LIVER TRANSPLANTATION IN A LIVER TRANSPLANTATION IN PATIENTS WITH
MULTICENTRIC HEPATOCELLULAR CARCINOMA HEPATOCELLULAR CARCINOMA
PATIENT SUBMITTED TO SYSTEMIC
CHEMOTHERAPY WITH SORAFENIBE Mariana D. C. Toro , Angela Cristina L. Malheiros , Jazon R. S. Almeida ,
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Tiago Seva-Pereira , Elaine C. Ataide , Adilson R. Cardoso ,
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Mariana D. C. Toro , Ilka Boin , Angela Cristina L. Malheiros , Cristina Aparecida A. Caruy , Raquel S. B. Stucchi , Ilka Boin
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Jazon R. S. Almeida , Tiago Seva-Pereira , Elaine C. Ataide , Adilson R. Cardoso , 1 Digestive Surgery, State University of Campinas, Campinas, Brazil
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Cristina Aparecida A. Caruy , Raquel S. B. Stucchi , Carmen S. P. Lima 1
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1 Digestive Surgery, State University of Campinas, Campinas, Brazil Corresponding author’s e-mail: ilkaboin@yahoo.com
Corresponding author’s e-mail: ilkaboin@yahoo.com
Introduction: Hepatocellular carcinoma (HCC) patients, with MELD higher than 10, are
indicated for liver transplantation rather than liver resection. However, in transplantation
Introduction: Orthotopic liver transplantation (OLT) is widely accepted as gold-standard surgery there is often the need for blood transfusion. To avoid homologous blood
treatment for cirrhotic patients with HCC, but this indication is limited by the Milan criteria.
transfusions, intraoperative blood salvage (IBS) is used. Nevertheless, the literature
Aims: The aim of this report was to show a successful case where the patient had HCC contraindicates the use of IBS in cases of carcinoma for the reason that it would reimplant
outside the Milan criteria and was submitted to liver transplantation after entering the Milan tumor cells in the bloodstream. Incidental findings of HCC in transplanted patients using
criteria. IBS allows the study of association of survival rates and tumor recurrence.
Methodology: A 51-year-old male with hepatic cirrhosis secondary to hepatitis C virus
infection, was reported to our service with hepatic mass in a screening examination. It Aims: To analyze the prognosis of patients with HCC, who were transplanted and
was confirmed as a 4.4cm HCC, grade II of Edmonson-Steiner, in segment VIII after MRI submitted or not to IBS. Also, to correlate the use of IBS with tumor recurrence (TR) and
scan and guided biopsy. The patient was included on the liver transplantation waiting list, survival rates (SVR).
but after tumor drop-out occurred was removed. At this time a CT scan showed a 6.4cm
HCC-compatible tumor and several small-HCC suspect images. Methodology: Eighty-three liver transplant patients with histological examination of HCC,
After a one-year period of Doxorubicin and Sorafenib based chemotherapy the patient incidental or otherwise, were selected between 1998 and 2010, and distributed into groups
had a repeat CT scan which found a reduction to 4.6cm in the main lesion, with no more
CLINICAL POSTER ABSTRACTS This was considered as a successful downstaging and the patient was transplanted with a nodules, use of blood products, duration of the surgery, length of hospital stay, donor`s CLINICAL POSTER ABSTRACTS
according to the use or not of IBS. In each subgroup the SVR, TR, number and size of liver
contrast enhancement, and the disappearance of the several small-HCC suspect lesions.
and recipients` data were analysed. The tests used were non-parametric and survival rate
deceased donor and piggyback technique with no major complications. At one year follow-
using Kapaln-Meyer and Cox hazard proportional regression.
up the patient showed no signs of recurrence on thoracic and abdominal scans while there
were normal alpha-fetoprotein and liver function
Results: In the graph 1 we can see the survival curves analyses. We observe that higher
Results: Histopathological analysis of liver explants shows a 3.2cm completely necrotic
tumor, grades I/II Edmonson-Steiner, ranging from 0.8 to 1.6cm. Eighteen months disease-
recurrence had lower survival but non related to IBS use.
free follow-up could be based on biological characteristics of the tumor or by effects of the MELD score and longer survival time in patients with TR - and IBS. The patients with tumor
chemotherapic treatment.
Conclusion: IBS can be used safely and has no influence on survival or TR after liver
Conclusion: Sorafenibe showed to be efficient in reducing and maintaining the control of transplantation.
HCC in a cirrhotic patient and also after the postoperative period.