Combined liver-intestinal and multivisceral transplantation for neuroendocrine tumors extending beyond the liver: A systematic literature review.

Transplant Rev (Orlando)

Leuven Intestinal Failure and Transplantation (LIFT) center, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium; Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Chronic Diseases and Metabolism (CHROMETA), Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, Belgium. Electronic address:

Published: January 2022

Background: Neuroendocrine tumors (NET) have an increasing incidence and are characterized by an invasive and metastatic presentation, rendering a curative resection not always feasible. For some patients the only life-saving option would be a multivisceral transplantation (MvTx). This systematic review aims to summarize the reported experience on combined liver-intestinal and MvTx for NET according PRISMA-guidelines.

Methods: PubMed, EMBASE and Cochrane Controlled Trial Reports were searched until April 7, 2020. Structured data abstraction was performed, and methodological quality assessed.

Results: Fourteen single-center and three multicenter retrospective studies reported on 1 combined liver-intestinal and 38 MvTx for NET. Nine previously unreported MvTx were added to the analysis. This review found that: i) overall patient survival of 51.2% is attainable; ii) recurrence of 35% is similar to recurrence after liver transplantation for NET; and iii) NET with diffuse abdominal presentation, normally considered a contraindication, could actually benefit from radical resection and MvTx. Data on tailoring of immunosuppression and (neo-)adjuvant treatment are limited, and further studies are needed to optimize post-transplant management.

Conclusions: Although results are encouraging, the reported MvTx experience for NET is limited and requires more detailed prospective multicenter studies and appropriate follow-up and reporting.

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http://dx.doi.org/10.1016/j.trre.2022.100678DOI Listing

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