Liver re-transplantation for donor-derived neuroendocrine tumor: a case report

Scientific paper - Case study

• Author: Anna Mrzljak
• Author: Branislav Kocman
• Author: Anita Škrtić
• Author: Ivana Furač
• Author: Jelena Popić
• Author: Lucija Franušić
• Author: Renata Žunec
• Author: Davor Mayer
• Author: Danko Mikulić
• Author's institution: University of Zagreb; School of Medicine; (Department of Internal Medicine)
• Author's institution: University of Zagreb; School of Medicine; (Department of Forensic Medicine)
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Forensic Medicine

Abstract (english)

Background: Donor-origin cancer is a well-recognized but rare complication after liver transplantation (LT). The rise in the use of extended criteria donors due to the current shortage of organs increases the risk. Data on donor-origin neuroendocrine neoplasms (NENs) and the most appropriate treatment are scarce. Here, we report a case of a patient who developed a NEN confined to the liver after LT and was treated with liver re-transplantation (re-LT).
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Case summary: A 49-year-old man with no other medical co-morbidities underwent LT in 2013 for alcoholic liver cirrhosis. The donor was a 73-year-old female with no known malignancies. Early after LT, a hypoechogenic (15 mm) lesion was detected in the left hepatic lobe on abdominal ultrasound. The lesion was stable for next 11 mo, when abdominal magnetic resonance identified two hypovascular lesions (20 and 11 mm) with atypical enhancement pattern. Follow-up abdominal ultrasound revealed no new lesions for the next 2.5 years, when magnetic resonance showed a progression in size and number of lesions, also confirmed by abdominal computed tomography. Liver biopsy proved a well-differentiated NEN. Genetic analysis of the NEN confirmed donor origin of the neoplasm. As NEN was confined to liver graft only, in 2018, the patient underwent his second LT. At 12 mo after re-LT the patient is well with no signs of NEN dissemination.
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Conclusion: The benefits of graft explantation should be weighed against the risks of re-LT and the likelihood of NEN dissemination beyond the graft.

• Keywords (english): Case report; Donor; Donor-origin tumor; Liver transplantation; Neuroendocrine tumor
• Language: english
• Publication type: Scientific paper - Case study
• Publication status: Published
• Peer review: Peer review
• Publication version: Published version
• Journal title: World Journal of Clinical Cases
• Numbering: vol. 7, no. 18, pp. 2794-2801
• p-ISSN: 2307-8960
• DOI: https://doi.org/10.12998/wjcc.v7.i18.2794
• URN:NBN: urn:nbn:hr:105:825464
• Publication: 2019-09-26
• Document URL: https://www.wjgnet.com/2307-8960/full/v7/i18/2794.htm
• Type of resource: Text
• Access conditions: Open access
• Created on: 2021-03-02 10:01:56