肝脏移植治疗肝癌八例

Liver transplantation for hepatocellular carcinoma: a report of 8 patients

目的 探讨肝脏移植治疗原发性肝癌的可行性。 方法 从 1995年 7月至 1998年 10月 ,玛丽医院共为 8例伴有肝硬化的肝癌患者行肝移植术。其中活体肝移植 2例 ,尸体肝移植 6例。5例术前已诊断为肝癌 ,3例为意外发现的肝癌。除 1例术前曾行抗癌治疗外 ,其余患者手术前后均未行任何抗癌治疗。TNM分期 :Ⅱ期 5例 ,Ⅲ期 2例 ,Ⅳa期 1例。术后患者平均随访 36个月。 结果 3例术后发生急性排斥反应 ,5例术后早期有并发症发生 ,均得到及时处理并缓解。 1例术后 1年死于败血症。术后 1年生存 8例 ,3年生存 7例。 结论 肝移植治疗肝癌是可行的。活体亲属肝移植可缓解供体短缺的矛盾及避免患者在等候肝移植期间病情恶化。

Objective[WT5”BZ] To evaluate the feasibility of liver transplantation as a treatment for hepatocellular carcinoma (HCC). [WT5”HZ]Methods[WT5”BZ] From July 1995 to October 1998, eight liver cancer patients with cirrhosis underwent liver transplantation in Queen Mary Hospital. The liver grafts were obtained from 6 brainstem dead donors and 2 living donors. Five patients had known HCC and 3 had incidental tumor identified in the explanted liver. TNM staging: stage Ⅱ (5 cases), stage Ⅲ (2 cases) and stage Ⅳa (1 case). After liver transplantation, the patients were followed up prospectively for a median of 36 months. Except for one patient who had preoperative chemotherapy, no anticancer treatment was given before and after transplantation. [WT5”HZ]Results[WT5”BZ] Three patients had acute rejection, 5 developed complication in early post transplantation. All were treated promptly and improved. One patient died one year after operation from septicemia. The recurrence free survival rates of one and three years were 100% and 83 3%, respectively. [WT5”HZ]Conclusions[WT5”BZ] Liver transplantation is a feasible method for treatment of HCC in selected patients. Living donor liver transplantation can overcome the problems of donor shortage and tumor growth while waiting for liver transplantation. [WT5”HZ]