Page 263 - ebook HCC

PROGRAMME
EASL HCC SUMMITHCC SUMMIT
GENEVA, SWITZERLANDA, SWITZERLAND
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260 PROGRAMME AND ABSTRACTSAND ABSTRACTS GENEV EASL 261
260
FEBRUARY 13 - 16, 2014Y 13 - 16, 2014
FEBRUAR
Poster Board Number C43
IMPACT OF THE IMMUNOSUPPRESSION IN THE
LATE RECURRENCE OF HEPATOCELLULAR
CARCINOMA AFTER SEQUENTIAL
TRANSPLANTATION LIVER-KIDNEY

Renato F. Da Silva , Dalisio D. S. Neto , Fabio L. C. Fernandes , Eighteen months after renal transplantation in routine examinations the alpha-fetoprotein
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Helen C. C. de Felício , Paulo C. Arroyo Júnior , Willian J. Duca , increased from 6.7 ng/ml to 232.6 ng/ml, TC Chest which identified nodules smaller
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Ida M. M. Fernandes , Rita C. M. A. da Silva 1 than 1 cm in the right lung and bone scintigraphy showed no metastasis. The patient
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1 General Surgery, Faculty of Medicine of São José do Rio Preto, underwent thoracotomy. The planned lobectomy was not performed due to disseminated
São José do Rio Preto, Brazil disease including pleura. Sorafenib was used, without response. The patient died 13
months after de recurrence and the histo-pathological exam demonstrated metastatic
Corresponding author’s e-mail: renatosilva@famerp.br HCC in lung with the same strain of the primary liver tumor.
Conclusion: These findings suggest a possible influence of increased
Introduction: The liver transplantation is one of the most effective therapeutic option for immunosuppressant schemes in later recurrence of HCC. This can be one more alert for
hepatocellular carcinoma (HCC) in early stage, however the recurrence can occur and is tailoring immunosuppresion even after double transplantation
more frequent within the first two or three years after the transplant. We describe a case
of late recurrence of HCC after sequential liver-kidney.
Aims: Discuss the possible influence of over immunosuppression related to late
recurrence of the tumor after sequential transplantation liver and kidney.
Methodology: We present a patient with late recurrence of HCC after sequential liver-
kidney transplantation. The recurrence occurred 101 months after transplantation of the
liver and 22 months after kidney transplantation, namely, very late recurrence compared
CLINICAL POSTER ABSTRACTS Results: Since May 2003 he underwent liver transplantation because of HCC, the CLINICAL POSTER ABSTRACTS
to liver transplantation and earlier in relation to kidney transplantation.

patient was stable and in use of low-dose of immunosuppresion: 1mg of Sirolimo
on alternative days and Mycophenolate Sodium 360 twice a day. In December 2009
after renal transplantation received high doses of immunosuppression: induction with
Thymoglobulin (ATG), in three doses, with a total dose of 4.5 mg\kg and corticosteroids
increased to 45 mg prednisone\day, Mycophenolate Sodium 720 mg twice a day and
Sirolimus was kept 1 mg every other day. Progressed to acute rejection eleven days
after the transplantation, which was treated with pulse Solumedrol 1gr for three days,
and then the prescription was maintained with prednisone at a dose of 25 mg twice a/
day, and Sirolimos was increased to 2 mg twice a day.