Orthotopic Liver Transplantation for Benign Hepatic Neoplasms

Abstract

Obiective: To evaluate the frequency and outcome of liver transplantation for symptomatic, unresectable. benign hepatIc neoplasms.hepatic lymphangiomatosis (n= 1), hilar fibrous angiodysplasia (n= 1). focal nodular hyperplasia (n= 1). and hemanglOma (n= I). There were three perioperative deaths and two late deaths at 56 and 84 months. The remaining patients are alive. 'With follow-up ranging from 36 to 145 months. Median survival for the nine patients who survived the perioperatIve period is 88 months. The early deaths were attributable to hemorrhagic complications (n=2) and necrotizing pancreatitis (n=1). The two late deaths were due to disseminated aspergillosis and hepatitis-associated cirrhosis.

Inflammatory process complicating giant hemangioma of the liver: Report of three cases

“…The well-known Kasabach-Merrit syndrome, which involves coagulopathy with fibrinolysis and thrombocytopenia associated with an hemangioma, 8 is also uncommon: 1 of 114 patients in the series of Iwatsuki et al, 2 2 of 109 patients in the series of Farges et al, 9 2 of 26 patients in the series of Egea et al, 10 and 2 of 24 patients in the series of Belli et al 5 In a few patients with contraindications to surgical excision, severe coagulation disorders have led to liver transplantation. 11,12 None of our patients presented signs of KasabachMerrit syndrome, and one presented with thrombocytosis related to the inflammatory process. Complications are generally uncommon in patients under observation for symptom-free giant LH.…”

Surgical Treatment of Giant Cavernous Hepatic Haemangiomas

“…Intraoperitoneal bleeding from rupture, which can either occur spontaneously or due to trauma, is a rare lifethreating complication [5]; it occurs in about 4% of patients but is fatal in 60% -75% [13]. In a recent review of literature, the operative mortality rate of ruptured haemangioma was reported to be 36.4% [14].…”

“…Strategies for the management of liver haemangioma have ranged from selective observation to a variety of radiological and surgical interventions [5]. While there is general agreement that small asymptomatic lesions should be managed conservatively, the surgical resection provides the only consistently effective method of treatment and is indicated for symptomatic lesions in patients with an acceptable surgical risk and lesions for which a diagnosis is equivocal despite appropriate preoperative evaluation [2].…”

Hemangioma hepático gigante asociado a síndrome de Kasabach-Merrit

“…En pacientes con sín-tomas sugestivos de compresión extrínseca se debe considerar la intervención quirúrgica, siendo más indicada la enucleación frente a la resección, debido a que presenta menor sangrado en el postoperatorio (13,14). El trasplante hepático se llevará a cabo en pacientes sintomáticos con lesiones irresecables o en caso de un hemangioma gigante con hemangiomatosis y asociados al síndrome de Kasabach-Merrit (15)(16)(17). En determinados casos se ha probado la eficacia de la embolización transarterial de los hemangiomas con mejoría rápida de la coagulopatía de consumo (18).…”