Surgical Options for Liver CancerOur liver cancer care team offers a variety of surgical options, including liver resection, liver transplants and hepatic artery infusion (HAI) in conjunction with targeted medical therapy.
Liver resection means the total or partial removal of the liver. For people diagnosed with liver cancer, liver resection may offer the best chance for cure or long-term survival because removal of a tumor is the most complete method of eliminating the cancer and preventing its spread to other parts of the body. The liver's remarkable ability to re-grow allows it to continue functioning even when parts of it are removed.
Only your surgeon can determine if you qualify for liver surgery. Some things we consider are:
- Whether the tumor is only in the liver
- The number, size and location of the liver tumors
- If you have enough healthy tissue for normal liver function after the diseased parts are removed. As much as 75 percent of the liver can taken out as the remaining tissue is healthy.
- Whether the tumor is near important blood vessels
- Whether you have cirrhosis of the liver.
Liver transplant is the only treatment for both liver cancer and any liver disease you already have. Liver transplant is an alternative liver cancer treatment. If chemotherapy, radiation and removing the tumor do not work well enough, getting a new liver could be an option. Below are the most common reasons for a liver transplant.
- Hepatitis C –New drugs are available to treat Hepatitis C, but a liver transplant is an option for some people.
- Liver cirrhosis –When the liver starts to fail, a transplant might be an option.
- Liver cancer –If chemotherapy, radiation and removing part of the liver are not enough, transplant might be a fit.
If you have liver cancer, you might qualify for a liver transplant if you already had chemotherapy and radiation. Your tumor should not be growing quickly. Also, it should not have spread to other areas of the body.
About liver transplant surgery
A liver transplant is surgery to replace a diseased liver with a healthy liver from someone else. Doctors remove the diseased liver and replace it with a whole new one or a piece of one.
The liver is the only body part that can grow back. So if you get part of a healthy liver, it can do the job of a whole liver in just a few weeks.
Read more about liver transplant surgery.
If I have a liver transplant, where does the new liver come from?
The new liver might come from someone who recently passed away and agreed to donate their liver. Or you might get part of a liver from someone who is alive. This might be a family member or someone else whose liver is a good match for you. Your donor can live a healthy life with the rest of their liver.
How well do liver transplants work?
Liver transplants usually work very well. Five years after surgery, more than 70 percent of liver transplant patients are still living. You might have heard about a problem called "rejection," where your body does not accept the new liver. While this happens sometimes, doctors can treat it. A successful liver transplant can last 20 years or more.
Having a liver transplant at OHSU
The only liver transplant program in Oregon is at OHSU. We have experienced specialists in liver disease, liver cancer and transplants. These doctors and other health care providers work together as a team to learn if you qualify for a liver transplant.
OHSU is also the only research university in Oregon. So our doctors and scientists also do research on liver cancer and other liver diseases. This helps us offer the most advanced treatments to you and others with liver cancer.
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Hepatic artery infusion (HAI) is a treatment for colon cancer that has spread to the liver. A self-contained pump is placed under the skin on your abdominal wall and connected to your main liver artery by a thin tube. With HAI, chemotherapy drugs are delivered straight to your liver via targeted therapy rather than throughout your body.
OHSU is one of few hospitals in the United States with an active HAI program. It is the only hospital on the west coast that currently offers HAI for colon cancer patients.
Who is a candidate for HAI?
You may be a candidate for HAI if:
- Colon cancer has spread to your liver and the cancer in your liver cannot be surgically removed.
- The cancer in your liver can be surgically removed, but your doctor has determined you may be at high risk for the cancer returning in your liver after treatment.
How does HAI work?
HAI therapy in combination with regular chemotherapy can shrink the cancer in your liver so that it can be surgically removed. Or if the cancer in your liver has already been removed, HAI can decrease the chance of it returning.
HAI has a number of potential benefits, including:
- It reduces the amount of chemotherapy that needs to be sent to other parts of your body.
- Therefore, side effects tend to be milder than those of regular chemotherapy.
- It delivers chemotherapy directly to your liver.
- You can remain mobile and active with HAI, though you must avoid strenuous activity such as contact sports.
Most importantly, compared to regular chemotherapy, HAI is more effective in fighting liver tumors.
What happens during surgery?
In the procedure, a surgical oncologist places the HAI pump under your skin. The surgeon will probably also remove your gall bladder and any lymph nodes that may obstruct the path to your liver.
After the HAI pump is placed in your body, our team at OHSU will monitor your liver’s response with periodic CT scans. When your doctor has determined that therapy is complete and the cancer in your liver has been surgically removed or there is no evidence of it returning to your liver for several years, your HAI pump can be removed in an outpatient procedure.