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Dendy MS, Camacho JC, Ludwig JM, et al. Infiltrative Hepatocellular Carcinoma With Portal Vein Tumor Thrombosis Treated With a Single High-Dose Y90 Radioembolization and Subsequent Liver Transplantation Without a Recurrence. Transplant Direct. 2017;3(9):e206doi: 10.1097/TXD.0000000000000707.
Dendy, M. S., Camacho, J. C., Ludwig, J. M., Krasinskas, A. M., Knechtle, S. J., & Kim, H. S. (2017). Infiltrative Hepatocellular Carcinoma With Portal Vein Tumor Thrombosis Treated With a Single High-Dose Y90 Radioembolization and Subsequent Liver Transplantation Without a Recurrence. Transplantation direct, 3(9), e206. https://doi.org/10.1097/TXD.0000000000000707
Dendy, Meaghan S, et al. "Infiltrative Hepatocellular Carcinoma With Portal Vein Tumor Thrombosis Treated With a Single High-Dose Y90 Radioembolization and Subsequent Liver Transplantation Without a Recurrence." Transplantation direct vol. 3,9 (2017): e206. doi: https://doi.org/10.1097/TXD.0000000000000707
Dendy MS, Camacho JC, Ludwig JM, Krasinskas AM, Knechtle SJ, Kim HS. Infiltrative Hepatocellular Carcinoma With Portal Vein Tumor Thrombosis Treated With a Single High-Dose Y90 Radioembolization and Subsequent Liver Transplantation Without a Recurrence. Transplant Direct. 2017 Aug 18;3(9):e206. doi: 10.1097/TXD.0000000000000707. eCollection 2017 Sep. PMID: 28894793; PMCID: PMC5585422.
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Transplant Direct. 2017 Aug 18;3(9):e206. doi: 10.1097/TXD.0000000000000707. eCollection 2017 Sep.

Infiltrative Hepatocellular Carcinoma With Portal Vein Tumor Thrombosis Treated With a Single High-Dose Y90 Radioembolization and Subsequent Liver Transplantation Without a Recurrence.

Transplantation direct

Meaghan S Dendy, Juan C Camacho, Johannes M Ludwig, Alyssa M Krasinskas, Stuart J Knechtle, Hyun S Kim

Affiliations

  1. Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
  2. Division of Vascular and Interventional Radiology, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC.
  3. Division of Interventional Radiology, Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT.
  4. Department of Pathology, Winship Cancer Institute of Emory University, Atlanta, GA.
  5. Duke Transplant Center, Department of Surgery, Duke University School of Medicine, Durham, NC.
  6. Yale Cancer Center, Yale School of Medicine, New Haven, CT.

PMID: 28894793 PMCID: PMC5585422 DOI: 10.1097/TXD.0000000000000707

Abstract

BACKGROUND: Infiltrative hepatocellular carcinoma with macrovascular invasion is a relatively rare presentation and usually fatal disease.

METHODS: Both patients exceeded Milan and University of California-San Francisco (UCSF) criteria, and per Barcelona Clinic Liver Cancer group guidelines, they were enrolled in a prospective open-label radioembolization phase II trial that gave them optimized lobar doses of Yttrium-90 as solely the first-line therapy without concomitant or additional pharmacological or locoregional therapies.

RESULTS: Three months after radioembolization, the patients demonstrated no residual viable disease on surveillance imaging. The patients were then followed up with serial imaging for 2 years in 3-month intervals, without documenting recurrence or extrahepatic disease. Finally, both patients underwent transplantation and after more than 20 months of imaging surveillance, no locoregional or systemic recurrence have been observed.

CONCLUSIONS: We present, to our knowledge, the first 2 reports of transplantation after successfully downstaging infiltrative disease with portal vein tumoral thrombosis, which traditionally poses as a relative contraindication for resection or transplantation.

Conflict of interest statement

The authors declare no funding or conflicts of interest.

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