1. Successful TACE for HCC

2. History
A 50 y/o white male with a history of HCV cirrhosis, who was referred for an evaluation for liver transplantation
Risk factors for HCV included: 1) Ex-IVDU in the 1960’s 2) Multiple blood transfusions in 1975

3. History
His end-stage liver disease was complicated by: 1) Esophageal variceal bleed 2) Portosystemic encephalopathy 3) Ascites 4) Hepatic lesion measuring 6 x 6.5 x cm in segment 7 with an elevated serum AFP > 16,000 ng/ml

4. Physical Examination HEENT: Sclera anicteric
ABD: Hepatomegaly of 16 cm, splenomegaly No shifting dullness
EXT: 1+ pitting edema of lower extremities. No asterixis
Neuro: AO x3

5. Laboratory Data
WBC /ul Albumin g/dl Hb g/dl AST 148 U/L Platelets 50/ul ALT 118 U/L Creatinine 1.0 g/dl INR MELD Total bili mg/dl AFP 13,874 ng/ml

6. Figure – 1 (CT scan of 1/29/02)

7. Subsequently in February 2002, He underwent chemoembolization with mitomycin, adriamycin and carboplatinum

8. Figure –2 (CT scan of 4/10/02)

9. Serial serum AFP levels decreased to:. - 164 ng/ml in 5/02
Serial serum AFP levels decreased to: ng/ml in 5/ ng/ml in 7/02

10. On August 25, 2002 the patient underwent cadaveric liver transplantation

11. Figure – 3 (Explant 8/25/02).

12. After 7 months of follow-up
The patient is doing well
There is no evidence of recurrence on serial abdominal imaging and serum AFP levels
Since there was no evidence of hepatocellular carcinoma on explant, the decision was made not to treat patient with chemotherapy