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Other “Bridge” Therapies for Liver Transplantation: RFA, TACE, and TARE

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Liver Transplantation and Hepatobiliary Surgery

Part of the book series: Updates in Surgery ((UPDATESSURG))

Abstract

Hepatocellular carcinoma (HCC) is the sixth cause of death among all cancers, and mainly arises on a background of liver cirrhosis. Liver transplantation (LT) is one of the best treatments since it simultaneously treats the HCC and the underlying liver cirrhosis. LT for HCC must be carried out within predetermined criteria (e.g., the Milan criteria) so as to achieve a transplantation benefit comparable to other patients. In order to avoid tumor progression and drop-out from the waiting list, locoregional treatments can be undertaken to control the tumor in patients with preserved liver function and bridge them to LT. The three main treatments available nowadays are: radiofrequency ablation (RFA), transarterial chemoembolization (TACE), and transarterial radioembolization (TARE). RFA is effective in patients with single lesions that are deeply located and less than 3 cm in size, while TACE and TARE are more used in patients with multinodular disease. The main concern of all these strategies is the effective tumor control and the risk of liver decompensation. Bridging treatments are a heterogeneous scenario in the setting of HCC, and locoregional treatments must be tailored to the patient, tumor characteristics and organ availability to improve HCC control and maximize the long-term outcomes.

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Authors and Affiliations

  1. Transplantation Department, S. Camillo-Forlanini Hospital, Rome, Italy

    Giuseppe Maria Ettorre & Andrea Laurenzi

  2. National Institute of Infectious Disease L. Spallanzani, Rome, Italy

    Giuseppe Maria Ettorre & Andrea Laurenzi

Authors
  1. Giuseppe Maria Ettorre
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  2. Andrea Laurenzi
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Correspondence to Giuseppe Maria Ettorre .

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Editors and Affiliations

  1. Department of Surgery, Oncology and Gastroenterology, University of Padua, Hepatobiliary Surgery and Liver Transplant Unit, Padua University Hospital, Padua, Italy

    Umberto Cillo

  2. Department of General Surgery and Transplantation, Niguarda Hospital, School of Medicine and Surgery University of Milano-Bicocca, Milan, Italy

    Luciano De Carlis

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Ettorre, G.M., Laurenzi, A. (2020). Other “Bridge” Therapies for Liver Transplantation: RFA, TACE, and TARE. In: Cillo, U., De Carlis, L. (eds) Liver Transplantation and Hepatobiliary Surgery. Updates in Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-19762-9_19

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  • DOI: https://doi.org/10.1007/978-3-030-19762-9_19

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-19761-2

  • Online ISBN: 978-3-030-19762-9

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