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PUBLIC PAGE
Tue, Nov 19 1:22pm

Liver Transplant for Cholangiocarcinoma

By Kristin Eggebraaten, Relations Coordinator, @keggebraaten

Mayo Clinic is one of the few centers in the United States that performs liver transplantation for cholangiocarcinoma (CCA). CCA is a cancer that forms in the slender tubes (bile ducts) that carry bile from the liver to the intestine. Cholangiocarcinoma obstructs the bile ducts and causes symptoms such as jaundice (yellow skin and eyes), abdominal pain, weight loss, generalized itching, and fever.2019-08-16 CCA Blog

Doctors divide cholangiocarcinoma into different types based on where the cancer occurs in the bile ducts:

  • Intrahepatic cholangiocarcinoma arises in the small bile ducts within the liver and is classified as a type of liver cancer.
  • Hilar cholangiocarcinoma occurs where the major bile ducts combine in the central portion of the liver and form the main bile duct that drains the liver.  Cancers arising in this location are treated with resection when possible. When resection is not possible, these cancers can now be treated with transplantation using the Mayo Clinic protocol.
  • Distal cholangiocarcinoma occurs in the portion of the bile duct that is nearest the small intestine. These cancers are best treated by surgical resection.

Your treatment options for your CCA will depend on the specifics of your cancer, such as the size, location and extent, as well as your health and personal preferences. At Mayo Clinic, your expert team works with you to find a treatment that meets your needs.

The 30 year risk of developing CCA is about 20% in patients with primary sclerosing cholangitis (PSC). Not everyone with PSC will get CCA and not everyone with CCA will qualify for liver transplantation. To be eligible for liver transplantation, patients with CCA must have the cancer diagnosis before the disease spreads beyond the liver. Once the disease is elsewhere in the body, a cure is not possible, and the immunosuppressive medications that patients need after transplantation could speed up the spread of the cancer cells.

Once a patient has been diagnosed with CCA and imaging shows that it has not spread outside the liver, the first step of the treatment process is three weeks of radiation treatment with concurrent and continuous infusion of chemotherapy medications. Patients then receive brachytherapy. This procedure involves placing radioactive material inside your body, also called “internal radiation”.  Patients are then treated with oral medications while they await transplantation.

All patients require a staging operation to rule-out spread of cancer prior to transplantation. During this operation, doctors will check the patient for cancer elsewhere in the body. Transplantation can be accomplished with either a deceased or living liver donor.  The waiting time for a deceased liver donor is usually more than a year. This time can be difficult for patients because they can develop infections or become sick with liver failure while waiting for a donor liver. The waiting time can be avoided if the patient has a living donor which would enable them to undergo transplantation much sooner than would otherwise be possible.

Have you been diagnosed with CCA? What were your treatment options?

HELPFUL LINKS

 

 

I would like to know about bone marrow transplant.
My father is in pain on his hand 🖐.
His having Gaut

COMMENT

His are painful,he can’t eat do anything.

EFD4681F-BA2D-41AF-9626-F23E44732AF4

COMMENT

@butana, I want to welcome you to Mayo Connect. I imagine that it ia difficult to see your dad in such pain. How long has this been going on? Is the gout affecting other parts of his body as well?
I have found some information related to Gout that I want to share here. And I do not see any mention of stem cell transplant for treatment for gout. According to the Mayo Clinic Patient Care & Health Information: Diseases & Conditions

"Treatment for gout usually involves medications. What medications you and your doctor choose will be based on your current health and your own preferences.
Gout medications can be used to treat acute attacks and prevent future attacks. Medications can also reduce your risk of complications from gout, such as the development of tophi from urate crystal deposits."
https://www.mayoclinic.org/diseases-conditions/gout/diagnosis-treatment/drc-20372903
Butana, what kind of treatment has your dad been receiving? What do they say about his current inability to do anything?

COMMENT

@butana, I would like to invite you to the Discussion Group > Bones Joints & Muscles > Gout*
You will meet others who have experience with gout. You can click on this link I provided, and you will be taken directly to the discussion where you can post your own questions. (Let me know if you need help )
https://connect.mayoclinic.org/discussion/gout-1/

COMMENT

My last blood test showed I had an elevated uric acid level but don’t seem to have classic symptoms of gout. Other reasons for elevated level? I had a liver transplant in 2012 and take Tacrolimus. Kidney function not the greatest !

COMMENT
@sjhoegh

My last blood test showed I had an elevated uric acid level but don’t seem to have classic symptoms of gout. Other reasons for elevated level? I had a liver transplant in 2012 and take Tacrolimus. Kidney function not the greatest !

Jump to this post

Hi @sjhoegh and welcome to Connect. Here is an article from Mayo Clinic describing possible causes of high uric acid levels.
High uric acid level: Causes https://www.mayoclinic.org/symptoms/high-uric-acid-level/basics/causes/sym-20050607

Given that you are a liver transplant recipient, you should report these levels to your transplant team.

I'd also like to invite you to follow the Transplants support group here: https://connect.mayoclinic.org/group/transplants/
You'll find many relevant discussions and so many supportive, informative fellow transplants recipients and donors to connect with.

COMMENT
@butana

I would like to know about bone marrow transplant.
My father is in pain on his hand 🖐.
His having Gaut

Jump to this post

@butana, has your father had a bone marrow transplant?

COMMENT
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