Super-fast-track discharge of liver transplant recipients
Adrenal and spinal metastases of hepatocellular carcinoma (HCC) are rare entities with significant morbidity and mortality, particularly after liver transplantation (LT). We report a case of a 49-year-old man who underwent LT for hepatitis B-related end-stage liver disease and HCC (single 4.5 cm les...
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| Format: | Article |
| Language: | English |
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Korean Society for Transplantation
2023-03-01
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| Series: | Korean Journal of Transplantation |
| Online Access: | http://www.ekjt.org/journal/view.html?doi=10.4285/kjt.23.0002 |
| _version_ | 1797328447106711552 |
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| author | Sapana Verma Lalit Kumar Das Selva Kumar Naganathan |
| author_facet | Sapana Verma Lalit Kumar Das Selva Kumar Naganathan |
| author_sort | Sapana Verma |
| collection | DOAJ |
| description | Adrenal and spinal metastases of hepatocellular carcinoma (HCC) are rare entities with significant morbidity and mortality, particularly after liver transplantation (LT). We report a case of a 49-year-old man who underwent LT for hepatitis B-related end-stage liver disease and HCC (single 4.5 cm lesion [T1N0], without vascular invasion) in 2016. Eighteen months later, adrenal metastasis and hepatitis B seropositive conversion were developed with normal serum tumor. Adrenal metastasis was treated with radiation therapy (RT) and hepatitis B showed spontaneous seronegative conversion. However, 35 months later, spinal metastasis occurred with elevation of the protein induced by vitamin K absence or antagonist-II (PIVKA-II) level (197 mAU/mL), along with hepatitis B seropositive conversion. After sorafenib, sequential regorafenib with RT led to partial response of the spinal lesions, along with hepatitis B seronegative conversion and normal PIVKA-II levels. After 9 months of regorafenib combined with RT, two recurrent lesions were found, as well as hepatitis B seropositive conversion and lesions were treated with transarterial chemoembolization. The patient survived for more than 71 months after LT and 53 months after recurrence under various combinations of therapy. Combined systemic and locoregional therapies can be a treatment option for HCC recurrence, even in LT patients. |
| first_indexed | 2024-03-08T06:51:56Z |
| format | Article |
| id | doaj.art-4b398cacf79e459e9391b7447f58798a |
| institution | Directory Open Access Journal |
| issn | 2671-8790 |
| language | English |
| last_indexed | 2024-03-08T06:51:56Z |
| publishDate | 2023-03-01 |
| publisher | Korean Society for Transplantation |
| record_format | Article |
| series | Korean Journal of Transplantation |
| spelling | doaj.art-4b398cacf79e459e9391b7447f58798a2024-02-03T06:45:51ZengKorean Society for TransplantationKorean Journal of Transplantation2671-87902023-03-01371767810.4285/kjt.23.0002kjt.23.0002Super-fast-track discharge of liver transplant recipientsSapana Verma0Lalit Kumar Das1Selva Kumar Naganathan2Liver Transplant Unit, Apollo Institute of Liver Sciences, Apollo Hospital, Chennai, IndiaDepartment of HBP and Liver Transplantation, Shahid Dharmabhakta National Transplant Center, Kathmandu, NepalLiver Transplant Unit, Apollo Institute of Liver Sciences, Apollo Hospital, Chennai, IndiaAdrenal and spinal metastases of hepatocellular carcinoma (HCC) are rare entities with significant morbidity and mortality, particularly after liver transplantation (LT). We report a case of a 49-year-old man who underwent LT for hepatitis B-related end-stage liver disease and HCC (single 4.5 cm lesion [T1N0], without vascular invasion) in 2016. Eighteen months later, adrenal metastasis and hepatitis B seropositive conversion were developed with normal serum tumor. Adrenal metastasis was treated with radiation therapy (RT) and hepatitis B showed spontaneous seronegative conversion. However, 35 months later, spinal metastasis occurred with elevation of the protein induced by vitamin K absence or antagonist-II (PIVKA-II) level (197 mAU/mL), along with hepatitis B seropositive conversion. After sorafenib, sequential regorafenib with RT led to partial response of the spinal lesions, along with hepatitis B seronegative conversion and normal PIVKA-II levels. After 9 months of regorafenib combined with RT, two recurrent lesions were found, as well as hepatitis B seropositive conversion and lesions were treated with transarterial chemoembolization. The patient survived for more than 71 months after LT and 53 months after recurrence under various combinations of therapy. Combined systemic and locoregional therapies can be a treatment option for HCC recurrence, even in LT patients.http://www.ekjt.org/journal/view.html?doi=10.4285/kjt.23.0002 |
| spellingShingle | Sapana Verma Lalit Kumar Das Selva Kumar Naganathan Super-fast-track discharge of liver transplant recipients Korean Journal of Transplantation |
| title | Super-fast-track discharge of liver transplant recipients |
| title_full | Super-fast-track discharge of liver transplant recipients |
| title_fullStr | Super-fast-track discharge of liver transplant recipients |
| title_full_unstemmed | Super-fast-track discharge of liver transplant recipients |
| title_short | Super-fast-track discharge of liver transplant recipients |
| title_sort | super fast track discharge of liver transplant recipients |
| url | http://www.ekjt.org/journal/view.html?doi=10.4285/kjt.23.0002 |
| work_keys_str_mv | AT sapanaverma superfasttrackdischargeoflivertransplantrecipients AT lalitkumardas superfasttrackdischargeoflivertransplantrecipients AT selvakumarnaganathan superfasttrackdischargeoflivertransplantrecipients |