Back to Search
Start Over
ABO-Incompatible Orthotopic Liver Transplant as a Rescue Strategy for Fulminant Hepatic Failure in a Recipient With Breast Cancer: Highlights on Transplant Management.
- Source :
-
Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation [Exp Clin Transplant] 2023 Sep; Vol. 21 (9), pp. 779-783. - Publication Year :
- 2023
-
Abstract
- Pretransplant malignancy unrelated to hepatocellular carcinoma is a challenging condition in liver transplantation. Standard of care requires the completion of treatments and a disease-free period before the transplant. However, in the setting of a fulminant hepatic failure, these steps cannot be achieved. A 46-year-old woman with a recent diagnosis of stage 2 breast cancer presented to our center with a fulminant hepatic failure of unknown origin. Because of the rapid worsening of her clinical status, she was listed as eligible for transplant after a multidisciplinary evaluation. Because of a shortage of available donors, a deceased donor ABO-incompatible liver transplant with a synchronous mastectomy and first-level axillary lymphadenectomy was performed. To prevent antibody-mediated rejection, a triple immunosuppression therapy and a postoperative therapeutic plasmapheresis were performed. The patient remains without cancer recurrence at 18 months of follow-up. Recent studies have shown that cancer recurrence in recipients with pretransplant malignancy is considerably lower than suggested in previously published studies. However,this data is not sufficient to establish evidence-based guidelines on the indications and timing of transplant. In selected cases, the presence of a pretransplant malignancy does notrepresent a contraindication for a rescue liver transplant. Further studies are needed to stratify the risk and to help clinicians to choose the best strategy in an urgent context such as this.
- Subjects :
- Humans
Female
Middle Aged
Blood Group Incompatibility
Mastectomy
Neoplasm Recurrence, Local
ABO Blood-Group System
Graft Rejection etiology
Living Donors
Liver Transplantation adverse effects
Breast Neoplasms surgery
Liver Neoplasms surgery
Liver Failure, Acute diagnosis
Liver Failure, Acute etiology
Liver Failure, Acute surgery
Subjects
Details
- Language :
- English
- ISSN :
- 2146-8427
- Volume :
- 21
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 37885295
- Full Text :
- https://doi.org/10.6002/ect.2023.0238