肝脏移植在治疗肝脏恶性肿瘤中的作用

Role of liver transplantation in treatment of liver malignancy

目的 探讨我国目前原位肝脏移植在治疗肝脏恶性肿瘤中的作用以及围手术期的处理 ,进一步提高肝脏移植治疗肝脏恶性肿瘤的疗效。方法 18例肝脏恶性肿瘤肝脏移植病人术后采用全身化疗 ,复发转移灶采用手术切除或介入化疗。结果 肝脏移植术后甲胎蛋白短期内降为正常者 6例 ,虽有下降但未降至正常者 2例。术后肝癌肝内复发 4例次 ,肺转移 3例次 ,骨转移 1例次 ,肿瘤复发多在术后 6～ 12个月。结论 (1)小肝癌、胆管细胞癌可行肝脏移植 ,中晚期肝癌行肝脏移植需综合考虑 ;(2 )

Objective To investigate the role of liver transplantation in treatment of liver tumors and measures taken during peri operative period to get better outcome of liver transplantation in liver malignancy patients. Methods A total of 18 patients with liver malignancy were treated with liver transplantation. Meanwhile, they received general chemotherapy post operatively. Those patients with recurrent tumors received tumor resection or interventional chemotherapy. Results After the transplantation, α fetoprotein (AFP) returned to normal in 6 patients while it dropped in the other 2. Four of the patients suffered from recurrent tumors in the liver, 3 from metastatic tumors in the lung and 1 from metastatic tumor in the bone. Tumor recurrence mostly occurred between the 6th and 12th month after the transplantation. Conclusions (1) Patients with small liver cancer and liver cholangiocellular carcinoma can be treated with liver transplantation. Those with liver unresectable tumors should be carefully considered upon doing the operation. (2) Recurrent and metastatic tumors can be managed with tumor resection or interventional chemotherapy.