Transplantacija jetre kod primarnih i sekundarnih tumora jetre

master's thesis

• Title (english): Liver transplantation in primary and secondary liver tumors
• Author: Marija Ćorić
• Mentor: Anna Mrzljak (mentor)
• Committee member: Rajko Ostojić (predsjednik povjerenstva)
• Committee member: Ivana Vuković Brinar (član povjerenstva)
• Committee member: Anna Mrzljak (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2024-09-11, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Transplantacija jetre predstavlja važnu metodu liječenja za različite maligne bolesti jetre. Dok
se glavnina transplantacija u malignomima provodi uslijed hepatocelularnog karcinoma,
indikacije za transplantaciju se kontinuirano proširuju te se transplantacija danas primjenjuje i
za određene oblike kolangiokarcinoma, hepatalni epitelioidni hemangioendoteliom, kao i za
izolirane jetrene metastaze kolorektalnog karcinoma i neuroendokrinih tumora.
Transplantacijska onkologija polje je koje spaja brojne grane medicine, a njenom razvoju
znatno je doprinijelo unaprjeđenje kirurških tehnika, proširenje izbora donora, optimizacija
kriterija za odabir primatelja, formiranje multinacionalnih udruženja sa svrhom bolje
dostupnosti transplantata, primjena novih imunosupresivnih protokola, bolje razumijevanje
biologije tumora i mnogi drugi uspjesi medicine. Hepatocelularni karcinom često je povezan sa
cirozom jetre. Transplantacija jetre je ključna opcija liječenja za neresektabilni HCC. Objava
Milanskih kriterija značila je preokret pri odabiru kandidata. Kriteriji su prošireni nastankom
UCSF kriterija, a danas se koriste i različiti noviji sustavi, kao što su MT2, French AFP ili
UPTS, koji u obzir uzimaju i biologiju tumora. Transplantacija jetre za kolangiokarcinom se
koristi selektivno zbog visokog rizika povrata, ali može biti uspješna u pažljivo odabranim
slučajevima intrahepatalnog kolangiokarcinoma. Hepatoepitelijalni karcinom je rijedak tumor
jetre gdje transplantacija često nudi dobre dugoročne rezultate. Neuroendokrine metastaze u
jetri mogu se liječiti transplantacijom u slučaju dobro diferenciranih tumora bez
ekstrahepatalnih metastaza, dok je transplantacija jetre za kolorektalne metastaze pokazala
poboljšane ishode u novijim studijama, ali još nije standardna praksa. Hrvatska se istaknula kao
zemlja s visokom stopom transplantacija jetre, posebice u kontekstu malignih bolesti.

Abstract (english)

Liver transplantation is an important treatment method for various malignant liver diseases.
While the majority of transplants for malignancies are performed due to hepatocellular
carcinoma, the indications for transplantation are continually expanding. Today, transplantation
is also used for certain forms of cholangiocarcinoma, hepatic epithelioid
hemangioendothelioma, as well as for isolated liver metastases from colorectal cancer and
neuroendocrine tumors. Transplant oncology is a field that integrates numerous branches of
medicine, significantly benefiting from advancements in surgical techniques, the expansion of
donor selection, optimization of recipient selection criteria, the formation of multinational
associations aimed at improving transplant accessibility, the application of new
immunosuppressive protocols, a better understanding of tumor biology, and many other
medical achievements. Hepatocellular carcinoma is often associated with liver cirrhosis. Liver
transplantation is a key treatment option for unresectable HCC. The publication of the Milan
criteria marked a turning point in candidate selection. These criteria were expanded with the
creation of the UCSF criteria, and today various newer systems are also used, such as MT2,
French AFP, or UPTS, which consider tumor biology. Liver transplantation for
cholangiocarcinoma is used selectively due to the high risk of recurrence, but it can be
successful in carefully selected cases of intrahepatic cholangiocarcinoma. Hepatic epithelioid
hemangioendothelioma is a rare liver tumor where transplantation often offers good long-term
outcomes. Neuroendocrine liver metastases can be treated with transplantation in the case of
well-differentiated tumors without extrahepatic metastases, while liver transplantation for
colorectal metastases has shown improved outcomes in recent studies, but it is not yet standard
practice. Croatia has distinguished itself as a country with a high rate of liver transplants,
especially in the context of malignant diseases.

• Keywords: hepatocelularni karcinom; jetra; transplantacijska onkologija
• Keywords (english): hepatocellular carcinoma; liver; transplant oncology
• Language: croatian
• URN:NBN: urn:nbn:hr:105:661552
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2024-08-21 15:41:56