Liver Transplant and Innovative Medicine
has Ronald Living Life to the Fullest Again
“It was a tough time, I wasn’t sure what was going on with me,” Ronald said.
He was diagnosed with hepatocellular carcinoma, a malignant tumor in his liver. Although the diseased portion of Ronald’s liver was successfully removed and he returned to an active life, he learned four years later that the cancer had returned. This time, he had several tumors in his liver. However, Allegheny General Hospital doctors felt encouraged about that the cancer had not spread to other parts of his body.
“Ronald had recurrent liver cancer,” says Ngoc Thai, MD, PhD, director of the Allegheny Health Network Liver Transplant Program. “Ronald was very lucky that his cancer hadn’t yet metastasized. That improved his prognosis tremendously. But Ronald needed a liver transplant soon; otherwise, the tumor would eventually spread beyond the liver.”
Because transplant eligibility is based on the size and number of tumors, Ronald’s physicians were faced with the challenge of shrinking the tumor while causing no harm to his liver, so they proposed a treatment plan known as “bridge-to-transplantation.”
“Our goal was to eradicate his tumor while keeping liver parenchyma unaffected by treatment. That would buy Ronald some time while he waited for a donor liver,” said Alexander Kirichenko, MD, PhD, an Allegheny Health Network Cancer Institute radiation oncologist.
Dr. Kirichenko proposed a novel alternative known as stereotactic body radiotherapy (SBRT) – a non-invasive radiation technique that precisely delivers high doses of radiation to isolated primary or metastatic liver tumors with minimal harm to surrounding healthy tissue. The Allegheny Health Network Cancer Institute is one of just a few leading medical centers in the world offering the innovative therapy.
Ronald needed only five SBRT treatments to shrink 90 percent of the tumors without harming the rest of his liver. During the next three months, he patiently waited for a liver until June 2010 when Dr. Thai and the transplant team replaced Ronald’s diseased liver with one from a donor. Ronald did remarkably well during the operation and was discharged from the hospital a week later.
“Before long, I regained much of my strength, and I’m back to walking my three dogs, dancing with my wife on weekends, doing yard work and traveling,” said Ronald, who will need to continue taking immunosuppression medications the rest of his life to prevent rejection in his liver.
Since Ronald was treated five and a half years ago, 26 other liver cancer patients have successfully undergone SBRT as a bridge-to-liver transplant procedure at the Allegheny Health Network. Just like Ronald, 18 of those patients have already received a liver transplant. In addition, more than 178 patients with primary and metastatic liver cancer – and not in need of a transplant – have been treated with SBRT.
“Liver cancer was once considered one of the most lethal and difficult forms of cancer to treat,” said Dr. Thai. “But the future for liver cancer is very exciting. With new technologies and a multidisciplinary approach, we are making dramatic improvements in survival rates and we are helping to improve the quality of life for many people.”