Liver transplantation may be the best option for some people with small liver cancers. At this time, liver transplants are reserved for those with small tumors (either 1 tumor smaller than 5 cm or 2 to 3 tumors no larger than 3 cm) that have not invaded nearby blood vessels. This criteria is called Milan Criteria. In most cases, transplant is used for tumors that cannot be totally removed, either because of the location of the tumors or because the liver is too diseased (cirrhotic) for the patient to withstand removing part of it. The 5-year survival rate for these patients is around 65% to 70%. Most livers for transplants come from people who have just passed away (brain dead). This is known as Cadaveric Liver Transplantation or Disease Donor Liver Transplantation (DDLT). The other option is to have a Living Donor Liver Transplantation where a family donor donates a part of liver to the cancer patient. The liver has a capacity to regenerate if a part of it is removed. The donated part of the liver and the remaining liver in the donor regenerates in two to three months. Still, the surgery does carry some risks for the donor.
People needing a transplant must wait until a liver is available, which can take too long for some people with liver cancer. In many cases a person may get other treatments, such as embolization or ablation, while waiting for a liver transplant. Or doctors may suggest a limited resection of the cancer or other treatments first and then a transplant if the cancer comes back. Unfortunately, the opportunities for liver transplants are limited. Increased awareness about the importance of organ donation is an essential public health goal that could make this treatment available to more patients with liver cancer and other serious liver diseases.
Cadaveric Liver Transplantation:
Living Donor Liver Transplantation:
Possible risks and side effects:
Like partial hepatectomy, a liver transplantation is a major operation with serious potential risks (bleeding, infection, blood clots, complications from anesthesia, etc.). But there are some additional risks after this surgery. People who get a liver transplant have to be given drugs to help suppress their immune systems to prevent their bodies from rejecting the new organ. These drugs have their own risks and side effects, especially the risk of getting serious infections. By suppressing the immune system, these drugs might also allow any remaining cancer to grow even faster than before. Some of the drugs used to prevent rejection can also cause high blood pressure, high cholesterol, diabetes, and can weaken the bones and kidneys. After a liver transplant, regular blood tests are important to check for signs of the body rejecting the new liver.
