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©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
De-novo hepatocellular carcinoma after pediatric living donor liver transplantation
Samuel Torres-Landa, Armando Salim Muñoz-Abraham, Brett E Fortune, Ananta Gurung, Jeffrey Pollak, Sukru H Emre, Manuel I Rodriguez-Davalos, Michael L Schilsky
Samuel Torres-Landa, Department of Gastrointestinal Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, United States
Armando Salim Muñoz-Abraham, Sukru H Emre, Manuel I Rodriguez-Davalos, Department of Surgery, Yale University School of Medicine, New Haven, CT 06510, United States
Brett E Fortune, Division of Gastroenterology and Hepatology, Weill Cornell Medicine, New York, NY 10021, United States
Ananta Gurung, Department of Pathology, Royal Columbian Hospital, New Westminster, British Columbia V3L 3W7, Canada
Jeffrey Pollak, Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT 06510, United States
Michael L Schilsky, Division of Digestive Diseases and Transplant and Immunology, Department of Medicine and Surgery, Yale University School of Medicine, New Haven, CT 06510, United States
Author contributions: Torres-Landa S, Munoz-Abraham AS, Fortune BE, Emre SH, Rodriguez-Davalos MI, and Schilsky ML contributed with the case report design, collecting the data and writing the manuscript; Gurung A helped with the pathology reports, pathology images description and analysis of the data; Pollak J helped with the radiology reports and analysis of the data.
Informed consent statement: The authors should be aware that at the time of publication, the covered entity does not have actual knowledge (any identifiers described by HIPAA) that the information could be used alone or in combination with other information to identify an individual who is subject of the information. According to the IRB review and HIPAA compliance we have removed all HIPAA identifiers as the consent was unable to obtain.
Conflict-of-interest statement: All the authors have no conflicts of interest to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Manuel I Rodriguez-Davalos, Associate Professor, Department of Surgery, Yale University School of Medicine, 333 Cedar St, New Haven, CT 06510, United States. rodriguezmi@me.com
Telephone: +1-203-7856501 Fax: +1-203-7374033
Received: August 25, 2017
Peer-review started: August 25, 2017
First decision: November 1, 2017
Revised: November 22, 2017
Accepted: December 7, 2017
Article in press: December 8, 2017
Published online: December 28, 2017
ARTICLE HIGHLIGHTS
Case characteristics
A 29-year-old male with a history of biliary atresia with failed Kasai procedure complicated with progressive cirrhosis and portal hypertension that received a left lateral segment living donor liver transplant (LDLT) from his biological father at 15 years of age.
Clinical diagnosis
Biliary atresia, complicated with progressive cirrhosis and portal hypertension that received a left lateral segment living donor liver transplant LDLT.
Differential diagnosis
A case of de-novo hepatocellular carcinoma (HCC) (confirmed by ultrasound-guided percutaneous biopsy of the mass) 14 years after a pediatric living related donor liver transplantation for end-stage liver disease without positive hepatitis B or C viral serology.
Imaging diagnosis
Follow up magnetic resonance imaging was performed 1.5 mo after the ablation and showed no residual tumor.
Treatment
The lesion was subsequently treated by percutaneous microwave ablation. The patient was subsequently listed for repeat liver transplantation. Current screening and treatment guidelines have not been well established.
Experiences and lessons
This increasing phenomenon challenges us to define the utility of screening and surveillance for HCC in these individuals.
