Liver transplantation is applicable to selected patients with hepatoma, cholangiocarcinoma and some metastatic tumors such as neuroendocrine tumors, colon carcinoma and certain sarcomas. In general these patients have an absence of portal hypertension and severe liver failure such that their operative and immediate postoperative care is relative uncomplicated. Although liver transplantation alone has produced some impressive results in a minority of patients, the majority of these patients do have recurrence of the original tumor. For this reason we have embarked on a variety of adjunctive measures including low dose immunosuppression, conventional chemotherapy, and highly experimental xenobiotic treatment protocols. The outpatient care of these patients is very similar to other liver allograft recipients except for close monitoring of the patients for signs of recurrence of the tumor.
Recurrence is treated with prompt resection and or experimental or classic chemotherapeutic regimes.
For further information in this field the reader is referred to a recent book chapter entitled, Liver Transplantation for Cancer authored by Drs.