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Orthotopic Liver Transplantation for Benign Hepatic Neoplasms

Konstantinos Tepetes, MD; Rick Selby, MD; Marc Webb, MD; Juan R. Madariaga, MD; Shunzaburo Iwatsuki, MD, PhD; Thomas E. Starzl, MD, PhD
Arch Surg. 1995;130(2):153-156. doi:10.1001/archsurg.1995.01430020043005.
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Objective:  To evaluate the frequency and outcome of liver transplantation for symptomatic, unresectable, benign hepatic neoplasms.

Design:  Retrospective study.

Setting:  Presbyterian University Hospital, a tertiary care referral center for liver transplantation affiliated with the University of Pittsburgh (Pa).

Patients:  All 3239 liver transplant recipients at the University of Pittsburgh from January 1981 until January 1993.

Results:  Twelve (0.37%) of 3239 patients required liver transplantation for benign, highly symptomatic hepatic neoplasms that were unresectable. Origins included adenoma (n=6), mesenchymal hamartoma (n=2), massive hepatic lymphangiomatosis (n=l), hilar fibrous angiodysplasia (n=1), focal nodular hyperplasia (n=1), and hemangioma (n=l). 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.

Conclusion:  Patients with severe symptoms from benign hepatic neoplasms that are not resectable can be treated by total hepatectomy and orthotopic liver transplantation, with the expectation of good long-term results.(Arch Surg. 1995;130:153-156)


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