Nature reviews. Gastroenterology & hepatology · 2009
Liver transplantation after radioembolization in a patient with unresectable HCC.
Клинический случайСтатьяПоддержка NIH: внешняя программаПоддержка исследования: вне правительства СШАОбзорНазвание и аннотация: Перевод пока не подготовлен
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Luna Laura E Moreno, Kwo Paul Y, Roberts Lewis R, Mettler Teresa A, Gansen Denise N, Andrews James C, Wiseman Gregory A, Misra Vijay Laxmi
Аннотация
BACKGROUND: A 58-year-old white man who was being followed by his hepatologist for nonalcoholic steatohepatitis-related liver cirrhosis and portal hypertension and who had been found to have a biopsy-proven hepatocellular carcinoma (HCC) on routine screening, self-referred to our center for a second opinion on the management of his HCC.
INVESTIGATIONS: Laboratory investigations, CT scan of the abdomen and chest, bone scan and technetium macroaggregated albumin scan.
DIAGNOSIS: The patient had unresectable HCC.
MANAGEMENT: The patient underwent two treatments with Yttrium-90 glass microspheres, which were performed as outpatient procedures 1 month and 3 months after diagnosis. He underwent orthotopic liver transplantation (OLT) 1 year after the initial diagnosis of HCC. The post-OLT immunoregimen included OKT3 plus rituximab and high-dose steroids. On discharge from hospital he was on immunosuppressive treatment with tacrolimus. He had de novo autoimmune hepatitis 6 months post-OLT, which was treated with a short course of low-dose steroids and addition of mycophenolate mofetil.
INVESTIGATIONS: Laboratory investigations, CT scan of the abdomen and chest, bone scan and technetium macroaggregated albumin scan.
DIAGNOSIS: The patient had unresectable HCC.
MANAGEMENT: The patient underwent two treatments with Yttrium-90 glass microspheres, which were performed as outpatient procedures 1 month and 3 months after diagnosis. He underwent orthotopic liver transplantation (OLT) 1 year after the initial diagnosis of HCC. The post-OLT immunoregimen included OKT3 plus rituximab and high-dose steroids. On discharge from hospital he was on immunosuppressive treatment with tacrolimus. He had de novo autoimmune hepatitis 6 months post-OLT, which was treated with a short course of low-dose steroids and addition of mycophenolate mofetil.