Our Summary

Colorectal cancer (CRC) is the third most common cancer worldwide. Majority of patients with CRC will experience liver metastases (spread of the cancer to the liver) at some point. Liver resection (surgical removal of part of the liver) is often the only potential cure. However, not all patients are suitable for this procedure. In these cases, liver transplantation may be an option.

Early experiences with liver transplantation for nonresectable CRC liver metastases (cancer that has spread to the liver and cannot be surgically removed) had disappointing results, with less than 20% of patients surviving 5 years post-transplant. However, these early studies did not have standard patient selection criteria or additional therapies before or after surgery.

Recent advances in surgical and medical treatment of cancer have changed this situation. New research from Norway shows a promising 5-year survival rate of 50% for patients with nonresectable CRC liver metastases who undergo liver transplantation.

A significant challenge is the shortage of organs available for transplantation. To address this, strategies using living liver donors are becoming more popular. Ongoing trials are investigating the effect of liver transplantation on patient survival rates for nonresectable CRC liver metastases.

Thus, this paper aims to review the current status of liver transplantation as a treatment option for nonresectable CRC liver metastases.

FAQs

  1. What is the potential benefit of liver transplantation for patients with nonresectable CRC liver metastases?
  2. How has the overall survival rate for patients with NRCLM changed with recent advances in surgical and medical oncology?
  3. What strategies are being used to manage the organ shortage for liver transplants?

Doctor’s Tip

A doctor might tell a patient considering a hand transplant to carefully follow post-operative instructions, including taking prescribed medications, attending regular follow-up appointments, and participating in physical therapy to ensure optimal function and healing of the transplanted hand. It is important to communicate any concerns or changes in symptoms to your healthcare provider promptly to avoid any complications.

Suitable For

Patients who are typically recommended for hand transplant are those who have lost a hand due to trauma, burns, congenital deformities, or other medical conditions. These patients must have a good overall health status, be mentally and emotionally stable, and have realistic expectations about the outcomes of the transplant surgery and the rehabilitation process. Additionally, candidates for hand transplant must be willing to commit to lifelong immunosuppressive therapy to prevent rejection of the transplanted hand.

Timeline

Before hand transplant:

  1. Patient experiences severe hand injury or loss due to trauma, disease, or congenital deformity.
  2. Patient undergoes thorough medical and psychological evaluations to determine eligibility for hand transplant.
  3. Patient may undergo physical therapy and counseling to prepare for the transplant surgery.
  4. Patient is placed on a waiting list for a suitable donor hand.

After hand transplant:

  1. Patient undergoes a complex surgical procedure to transplant a donor hand onto their arm.
  2. Patient is closely monitored in the hospital for signs of rejection or complications.
  3. Patient undergoes intensive rehabilitation therapy to regain function and sensation in the transplanted hand.
  4. Patient continues long-term medication to prevent rejection of the transplant.
  5. Patient undergoes regular follow-up appointments with healthcare providers to monitor the success of the transplant and overall health.

What to Ask Your Doctor

  1. Am I a candidate for a hand transplant?
  2. What are the risks and potential complications of a hand transplant?
  3. How long is the recovery process after a hand transplant?
  4. What kind of rehabilitation will I need after a hand transplant?
  5. What are the long-term expectations for function and appearance of the transplanted hand?
  6. How will I need to adjust my lifestyle after a hand transplant?
  7. What kind of follow-up care will be required after a hand transplant?
  8. Are there any alternative treatments or therapies that may be more suitable for my situation?
  9. How many hand transplants have you performed, and what is your success rate?
  10. What is the expected outcome for patients with similar circumstances to mine who have undergone a hand transplant?

Reference

Authors: Gorgen A, Muaddi H, Zhang W, McGilvray I, Gallinger S, Sapisochin G. Journal: Can J Gastroenterol Hepatol. 2018 Jan 10;2018:9531925. doi: 10.1155/2018/9531925. eCollection 2018. PMID: 29623268