Total hepatectomy and liver replacement (orthotopic liver transplantation) for primary hepatic malignancy

Abstract

There has been a high incidence of tumor recurrence after liver transplantation for primary hepatic malignancy. Nevertheless, a small but significant palliation has been possible with this approach, even in patients who eventually died of recurrence. Two patients with incidental malignancies in their excised livers apparently have been cured. Further gains will be possible only with extremely discriminating selection of prospective recipients.

Fig. 1

Actuarial survival of 24 patients with primary liver malignancy treated by total hepatectomy and transplant (open circle with solid line), and of 15 patients excluding operative deaths (closed circle with solid line) in comparison to the survival of 30 patients with primary liver malignancy treated by subtotal hepatectomy (closed circle with broken line).