Multivisceral transplantation for the treatment of intra-abdominal tumors.

Abstract:

BACKGROUND:Some intra-abdominal or retroperitoneal tumors such as low-grade slow-growing malignancies may seem unresectable due to major vessel encasement or presence of intra-abdominal dissemination, but the slow growth rate and to some extent long life expectancy of the patients urge us to find some strategies to cure the patients or at least achieve tumor remission or symptom palliation. En bloc resection, followed by multivisceral or liver-sparing "modified" multivisceral transplantation has recently been used for treatment of these patients. RESULTS:Between May 2010 and October 2012, 3 multivisceral and 3 modified multivisceral transplantations were performed in 6 patients (aged 14 to 55 years; mean, 32 years) with some slow growing intra-abdominal malignancies (2 neuroendocrine tumors, 2 gastrointestinal stromal tumors, 1 desmoid tumor, and 1 low-grade sarcoma). All patients survived the procedure. One patient died of pancytopenia 2 months after transplantation and another died with pulmonary emboli at 4 months. The remaining 4 patients are alive without any evidence of disease recurrence. CONCLUSIONS:Although large intra-abdominal desmoid tumors, well-differentiated neuroendocrine tumors, and gastrointestinal stromal tumors are slow growing, they tend to invade locally, especially to the mesenteric root and/or celiac axis and other abdominal viscera. Complete resection followed by multivisceral transplantation could be a therapeutic option for these advanced tumors.

journal_name

Transplant Proc

authors

Nikeghbalian S,Aliakbarian M,Shamsaeefar A,Kazemi K,Bahreini A,Malekhosseini SA

doi

10.1016/j.transproceed.2013.09.002

subject

Has Abstract

pub_date

2013-01-01 00:00:00

pages

3528-30

issue

10

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(13)00912-3

journal_volume

45

pub_type

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