Year 2016 / Volume 108 / Number 6
Letter to the Editor
Indication for liver transplantation in a patient with a history of a gastric lymphoma

379

DOI: 10.17235/reed.2016.4191/2015

José Ruiz Pardo, Pedro Antonio Cascales Campos, Pascual Parrilla Paricio,

Abstract
The indication for liver transplantation in patients with history of lymphoma is little-known, and the references documented in the medical literature are still limited. We present the case of a 63-year-old man who was diagnosed with chronic hepatopathy due to HBV 15 years ago. He was operated on for hepatocellular carcinoma in the segment VI of the liver 4 years ago, finding a macronodular liver cirrhosis during the surgery. Fifteen months later, the patient was diagnosed with diffuse large B-cell gastric lymphoma (fig.1). After a good response to chemotherapy treatment with R-CHOP scheme, the patient has been in complete remission for 36 months. Currently, the patient has a Child-Pugh score of 5 points, MELD score of 6 points, an undetectable viral load and it does not exist any evidence of hepatocellular carcinoma recurrence. With respect to this case, could it be considered liver transplantation in any assumption or would it be rejected in any case due to the recent history of lymphoma? In this case report, it has decided to do a periodic follow-up of the patient, but because of the good prognosis of the lymphoma, liver transplantation may be performed in the case of hepatocellular recurrence, worsening of liver function (Child-Pugh B or C) or fulminant hepatic failure due to HBV reactivation. There is not yet consensus about the interval between lymphoma remission and liver transplantation, therefore it recommends an individual oncologic evaluation in order to establish the recurrence risk before deciding on the indication for liver transplantation.
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References
1. Benten D, Sterneck M, Panse J, et al. Low recurrence of preexisting extrahepatic malignancies after liver transplantation. Liver Transpl. 2008;14:789-98. DOI: 10.1002/lt.21434.
2. Sociedad Española de Trasplante Hepático. Consensus document of the Spanish Society of Liver Transplantation. Gastroenterol Hepatol. 2008;31:82-91. Spanish. DOI: 10.1157/13117010.
3. Sperl J, Frankova S, Kieslichova E, et al. Urgent liver transplantation for chemotherapy-induced HBV reactivation: a suitable option in patients recently treated for malignant lymphoma. Transplant Proc. 2013;45:2834-7. DOI: 0.1016/j.transproceed.2013.03.047.
4. Kim JM, Kwon CH, Joh JW, et al. Liver transplantation in lymphoma patients with hepatitis B virus reactivation. Transplant Proc. 2013;45:2988-91. DOI: 10.1016/j.transproceed.2013.08.085.
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Ruiz Pardo J, Cascales Campos P, Parrilla Paricio P. Indication for liver transplantation in a patient with a history of a gastric lymphoma. 4191/2015


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Publication history

Received: 04/01/2016

Accepted: 22/01/2016

Online First: 03/03/2016

Published: 03/06/2016

Article Online First time: 59 days

Article editing time: 151 days


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