Significance of interventional radiology in liver transplantation

Abstract

Liver transplantation is a method that allows treating of various liver pathological conditions. Interventional radiology (IR) focuses on oncology patients, primarily those with hepatocellular carcinoma. The importance of interventional radiology techniques is in preventing the progression of current liver disease in those patients awaiting liver transplantation and downstaging in patients with unresectable liver tumors to the stage where transplantation is possible. Chemoembolization (TACE), i.e., conventional transarterial chemoembolization (cTACE) or with drug particles (DEB-TACE), radioembolization (SIRT), BLAND embolization, radiofrequency ablation (RFA), and microwave ablation (MWA) are the most widely used IR methods in the treatment of liver cancer. cTACE is a form of TACE in which a high dose of cytostatic is injected into the feeding vessel and the tumor's microenvironment, and then the blood vessels that feed the tumor are embolized. DEB-TACE is a form of TACE in which a cytostatic bind to bead particles that gradually release the drug within the liver tumor itself after injection. BLAND embolization is an IR method of TACE based on ischemia of tumor tissue by IR procedure of embolization and occlusion of the feeding vessel that supplies the tumor, without the use of chemotherapeutics. Transarterial radioembolization is a method that uses endovascular techniques to bring radiospheres containing a radioactive substance near the tumor. Radiofrequency ablation (RFA) is an IR percutaneous method of treatment in which an RF needle inserted into a liver tumor releases heat that causes coagulation necrosis of tumor cells. MWA is an IR percutaneous method of treatment that uses molecules with an internal dipole moment, which move kinetic energy and then heat inside the tumor via a percutaneously inserted MWA needle into the tumor.