2. Liver transplantation:
Total hepatectomy with orthotopic liver transplant which means taking out the diseased liver and replacing it by a new one from a healthy living donor or a cadaveric donor. This is best reserved for patients with cirrhosis in whom resection isn’t an option for cure. there are certain criteria called the MILAN criteria that are used to select the patients in whom transplant would be a great option with higher chances of recovery, and it includes:
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- Not being a candidate for resection
- One massthat is <5cm
- Less than three masses each of them not exceeding 3 cm
- Tumor without portal or hepatic vein invasion
- Tumor without extra hepatic metastasis
These criteria, if fulfilled, puts the patient on a waiting list for liver transplant until a donor is found. If the case is critical, the patient can use a bridging treatment modality like radiofrequency ablation or trans arterial chemoembolization (TACE) to make sure the condition doesn’t deteriorate any further.
It is a great option but many people can’t afford the transplant fees or may live in an area with no big centers that perform this type of surgery that requires a specialized center with extensive expertise in doing this operation another obstacle is that the transplant isn’t the end of treatment the patient must live on immunosuppressants which have a ton of effects on the body, but are necessary for the overall survival of the patient to avoid getting host graft rejection, so it is definitely not suitable solution for all types of patients.
