Role of Transplant in Biliary Disease

Romine, Margaret M.; White, Jared

doi:10.1016/j.suc.2018.12.009

Cited by 5 publications

(3 citation statements)

References 76 publications

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“…To identify patients with pCCA tumors who have the “best” biology, LT should be part of a multimodal protocol that includes neoadjuvant therapy followed by repeat staging (Figure 1). Because up to 20% of patients with pCCA harbor occult metastases, diagnostic laparoscopy or laparotomy with portal node sampling is used to evaluate for metastatic disease . One lymph node along the proper hepatic artery and common bile duct is typically excised and evaluated, as nodal metastasis is a contraindication to LT .…”

Section: Discussion and Observationsmentioning

confidence: 99%

Liver Transplant as a Treatment of Primary and Secondary Liver Neoplasms

Gorji,

Brown,

Limkemann

et al. 2024

JAMA Surg

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ImportanceLiver malignancies are an increasing global health concern with a high mortality. We review outcomes following liver transplant for primary and secondary hepatic malignancies.ObservationsTransplant may be a suitable treatment option for primary and secondary hepatic malignancies in well-selected patient populations.Conclusions and RelevanceMany patients with primary or secondary liver tumors are not eligible for liver resection because of advanced underlying liver disease or high tumor burden, precluding complete tumor clearance. Although liver transplant has been a long-standing treatment modality for patients with hepatocellular carcinoma, recently transplant has been considered for patients with other malignant diagnoses. In particular, while well-established for hepatocellular carcinoma and select patients with perihilar cholangiocarcinoma, transplant has been increasingly used to treat patients with intrahepatic cholangiocarcinoma, as well as metastatic disease from colorectal liver and neuroendocrine primary tumors. Because of the limited availability of grafts and the number of patients on the waiting list, optimal selection criteria must be further defined. The ethics of organ allocation to individuals who may benefit from prolonged survival after transplant yet have a high incidence of recurrence, as well as the role of living donation, need to be further discerned in the setting of transplant oncology.

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Section: Discussion and Observationsmentioning

confidence: 99%

Liver Transplant as a Treatment of Primary and Secondary Liver Neoplasms

Gorji,

Brown,

Limkemann

et al. 2024

JAMA Surg

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“…Congenital cystic dilations of the bile duct in adults are rare, for Valayer cystic dilation of the extrahepatic bile duct (CHD) would occur in 1 out of 2 million births 16 ; other western authors report incidence of 1 in 100,000 to 190,000 live births [4][5][6][7][8][9][10][11][12][13][14][15] ; the incidence in the East would be much higher, being reported as 1 in 1,000 births in some Asian populations 3,4,19 . The female gender is more affected in the cystic dilation of the extrahepatic bile duct with…”

Section: Discussionmentioning

confidence: 99%

“…Vater was who first described a congenital dilatation of the extrahepatic bile duct, but was Douglas' description in 1852 that gave full knowledge about this rare affection [17][18][19] . On the other hand, Jacques Caroli described in 1958 the congenital cystic dilatation of the intrahepatic bile duct as an infrequent cause of intrahepatic cholestasis 9,10,12 . These dilatations are characterized by their polymorphism as the dilatations can affect any part of the bile duct.…”

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confidence: 99%