Living donor liver re-transplantation for recurrent hepatoblastoma in the liver graft following complete eradication of peritoneal metastases under indocyanine green fluorescence imaging

Nobuhiro Takahashi, Yohei Yamada, Ken Hoshino, Miho Kawaida, Teizaburo Mori, Kiyotomo Abe, Takumi Fujimura, Kentaro Matsubara, Taizo Hibi, Masahiro Shinoda, Hideaki Obara, Kyohei Isshiki, Haruko Shima, Hiroyuki Shimada, Kaori Kameyama, Yasushi Fuchimoto, Yuko Kitagawa, Tatsuo Kuroda

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)

Abstract

The curability of chemotherapy-resistant hepatoblastoma (HB) largely depends on the achievement of radical surgical resection. Navigation techniques utilizing indocyanine green (ICG) are a powerful tool for detecting small metastatic lesions. We herein report a patient who underwent a second living donor liver transplantation (LDLTx) for multiple recurrent HBs in the liver graft following metastasectomy for peritoneal dissemination with ICG navigation. The patient initially presented with ruptured HB at 6 years of age and underwent 3 liver resections followed by the first LDLTx with multiple sessions of chemotherapy at 11 years of age. His alpha-fetoprotein (AFP) level increased above the normal limit, and metastases were noted in the transplanted liver and peritoneum four years after the first LDLTx. The patient underwent metastasectomy of the peritoneally disseminated HBs with ICG navigation followed by the second LDLTx for multiple metastases in the transplanted liver. The patient has been recurrence-free with a normal AFP for 30 months since the second LDLTx. To our knowledge, this report is the first successful case of re-LDLTx for recurrent HBs. Re-LDLTx for recurrent HB can be performed in highly select patients, and ICG navigation is a powerful surgical tool for achieving tumor clearance.

Original languageEnglish
Article number730
JournalCancers
Volume11
Issue number5
DOIs
Publication statusPublished - 2019 May

Keywords

  • Hepatoblastoma
  • Indocyanine green
  • Living donor liver transplantation
  • Transplant oncology

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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