Korean J Transplant.  2022 Nov;36(Supple 1):S328. 10.4285/ATW2022.F-4689.

Successful downstaging treatment of hepatocellular carcinoma with trans arterial chemoembolization followed by liver transplantation

• Batsaikhan T
• Semedperlii M
• Samaindagva B
• Tsogtbaatar T
• Narangerel Y

• KMID: 2535555
• DOI: http://doi.org/10.4285/ATW2022.F-4689

Abstract

Background
The hepatocellular carcinoma (HCC) is the leading and the most common cancer of Mongolia. The Interventional radiology department of National cancer center of Mongolia performed 1200 trans arterial chemoembolization (TACE) and 400 ablations for HCC this year. The department is the largest IR department of Mongolia. Since, the TACE is a treatment, not a cure, we are still seeking TACE as a bridge treatment for Liver transplantation. Seventy percent of HCC patients in Mongolia is diag-nosed in the advanced stage, which are beyond Milan criteria. Therefore, we are presenting successful downstaging treatment of HCC with TACE followed by living donor liver transplantation (LDLT).
Methods
The patient underwent conventional TACE with Lipiodol Doxorubicin 3:1 emulsion and 150–350 micron Gelfoam as an embolic agent.
Results
A 53-year-old man, was diagnosed multiple HCC with advanced liver cirrhosis Child-Pugh C. The HCC were located in S5 and S6 of the liver. S5 was measured 5.0 cm and second one in S6 was measured 3.0 cm in diameter, which was beyond Mi-lan criteria. Then, our multidisciplinary team discussed on this patient and decided TACE treatment. After three times of TACE treatment, tumor was controlled and shrunken by size and undergo for Milan criteria. The patient underwent successful LDLT and followed by IR department, without any recurrence.
Conclusions
The advanced stage of HCC is a complicated and often continuous with poor prognosis and there is only limited treatment available for it. But for some patients, if we treat them successfully and downstage the HCC, there's still little hope for further radical treatment option such as liver transplantation. This case shows TACE is a successful treatment for advanced HCC in well selected case.