In living donor liver transplant (LDLT), it is recommended to have a minimum graft recipient body weight ratio (GRBWR) 0.8 for good outcomes. Recent reports have, however, shown that good outcomes can be obtained even with GRBWR less than 0.8. We hypothesized that in patients receiving a graft with GRWR less than 0.8 absolute graft weight rather than GRBWR may be more relevant for predicting good outcome. Early post-transplant outcomes were assessed in adult patients undergoing elective right lobe LDLT. Patients were categorized as having good (survival) or poor (mortality) outcome. A ROC curve was drawn based on their graft weights and a cutoff value that provided the highest sensitivity and specificity for a good outcome was chosen. 147 patients received right lobe grafts with GRBWR less than 0.8. The 90-day mortality rate was 13.6% (n = 20). AUROC was 67.7%. Graft weight cutoff of 643 g gave the best combination of sensitivity (51.2%) and specificity (77.8%). There were 15 (19.4%) deaths in group with graft weight less than 643 g compared to 5 (7.1%) patients with graft weight 643 g or above. This cutoff value of 643 g (rounded of to 650 g) gave a positive predictive value (PPV) of 94%.
How to cite this article: Selvakumar N, Saboti P, Kaul S, Gupta S. First case report of inflammatory myofibroblastic tumor of peritoneal cavity in a living donor liver transplantation recipient. Hepatoma Res 2017;3:86-9.Post-transplantation malignancies are well known complications after liver transplantation. Certain malignancies are more common in pediatric recipients than adults. Inflammatory myofibroblastic tumors (IMTs) are reactive neoplasms with miniscule malignant potential. IMTs are more common after hematopoietic stem cell transplantation. However, there is 1 case reported in the literature after deceased donor liver transplantation. The authors describe a case of IMT after living donor liver transplantation. The patient was a 1-year-old girl who underwent living donor liver transplantation (LDLT) for decompensated cirrhosis secondary to extra hepatic biliary atresia. Six months post LDLT routine ultrasonography revealed multiple solid abdominal masses. Repeated biopsies were inconclusive. Hence surgical excision was carried out. Histopathological examination revealed IMT. Immunohistochemistry was positive for anaplastic-lymphoma kinase activity. Ceritinib, a tyrosine kinase inhibitor, was used as adjuvant chemotherapy for 1 year. At 1.5 years (at the time of writing this paper) of follow-up, the child was disease free on imaging (whole body positron emission tomography-computed tomography). This will be the first case of IMT after LDLT to be reported in the literature.
Key words:Inflammatory myofibroblastic tumor, living donor liver transplantation, extrahepatic biliary atresia
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