*Purpose: Here, we describe a new approach using Rapid Procedure, a 2 stage hepatectomy technique, with living donor liver transplantation (LDLT) in the cirrhotic setting with hepatocellular carcinoma (HCC).

*Methods: The patient was a 49 yo woman, cryptogenic liver cirrhosis with jaundice was found to have 3 cm mass consistent with HCC. She was 88 kilograms with a BMI of 35. A PET scan showed no extrahepatic disease. In the first stage; a left lateral sectionectomy and orthotopic left lobe LDLT (305ml, 314grams) (GRWR:0.35) was performed with a hemiportacaval shunt formation(figure1). There was a linear graft volume hypertrophy; 400 m in 7 days then 490 ml in day 22, a 60% increase from original volume (figure 2) and hepatoscintigraphy showed a functional shift of more than 60% to the graft (figure 3)After an interval of 34 days; remnant diseased liver was resected, portacaval shunt was closed following splenic artery ligation in the second stage

*Results: The Patient was discharged 24 days after second operation. Currently, she is doing well 228 days after first stage with a functioning liver and no evidence of tumor recurrence.

*Conclusions: This operation potentially provides a timely curative treatment for patients with cirrhosis who has limited graft and donor options and shifting the risk to the recipient rather than the donor by harvesting a smaller graft using inflow modification techniques.

« Back to 2020 American Transplant Congress