Re: Cholangiocarcinoma

[Guest guest]

,

That is what happened to 2, only with a cadaveric liver. She

got the call for transplant and when they got in there they could see

the CC, so they closed her back up. The game plan was for them to do

internal and external radiation, and chemo. If they could get rid of

the tumor then she was going to a transplant center that does tx's post

CC (like Mayo, ville, Fl). She got off to a good start, but

ended up hospitalized with a severe infection in her bile ducts. They

went in and placed stents but the infection got out of control and got

into her blood stream. They did all they could, even replaced her

blood, but they couldn't get the infection under control.

It may be different with a live donor, as long as the live donor is

still willing and healthy once the PSCer gets rid of the cancer.

However, I know from talking with my docs and that there are a

few more risks with a live donor (getting only a PORTION of a liver)

and they may not be willing to take those extra risks post CC.

[From what I understand they do not move forward with tx after finding

the CC. The reason being, which does make sense to me, is that they do

not know if the cancer is contained within the liver until further

testing. If it has spread then putting the patient on immunosuppressant

drugs post tx, gives the cancer the perfect place to flourish. All of

this is very sad, but as I said, it does make sense to me.]

1

***

What happens if when they go in to transplant someone (who is

receiving a living donor), and the find CC? Would they close them back

up? Or would they allow the transplant under those circumstances?

[Guest guest]

See ,

That just makes

me nuts. Are the dosages of immunosuppressants you are on pre-transplant a lot

less than what we would see post-transplant? I have to assume so. Otherwise,

all this Imuran that Noah gets daily…could that cause him trouble with

the CC? I know it takes time for all this, but my thought here is …he

has plenty of time being only 8. I obsess about things sometimes, and I am

sure I annoy some with all my what-ifs, but it is part of my thinking process.

Give Life!

[Guest guest]

Here's the answer I

got when asking the same question to the Doctors at the s Hopkins

Hospital in Baltimore:

2-

Basically, both

in cadaveric and live donor liver transplantation, you, the patient,

would be explored initially in the OR. If the surgeons do discover

Cholangiocarcinoma during exploration, then you would be closed. The

deceased donor liver would be offered to another patient. In the case

of live donation, the liver segment would not have been removed yet

from the live donor.

Also, most of the

studies have shown that the outcomes of performing liver transplant

surgery on patients with cholangiocarcinoma are poor. We would have to

have to have significant evidence that the patient does in fact have

cholangiocarcinoma prior to ruling them out as a candidate. Once it

is diagnostically proven that the patient has cholangiocarcinoma, then

the patient would not be a candidate for both deceased and live donor

liver transplantation. At that point in time, the patient would be

referred for treatment of the cholangiocarcinoma.

Mike Z

--

(no subject)

Mike Z, 34, PSC 99, Severna Park, MD

wrote:

What

happens if

when they go in to transplant someone (who is receiving a living

donor), and

the find CC? Would they close them back up? Or would they allow the

transplant under those circumstances?

Mom

of Noah (8)

UC, PSC, osteopenia ‘05