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Isolated hepatic perfusion as a treatment for liver metastases of uveal melanoma.

Journal article
Authors Ilan Ben-Shabat
Christoffer Hansson
Malin Sternby Eilard
Christian Cahlin
Magnus Rizell
Per Lindnér
Jan Mattsson
Roger Olofsson Bagge
Published in Journal of visualized experiments : JoVE
Issue 95
Pages 52490
ISSN 1940-087X
Publication year 2015
Published at Institute of Clinical Sciences, Department of Surgery
Pages 52490
Language en
Links dx.doi.org/10.3791/52490
Subject categories Surgery

Abstract

Isolated hepatic perfusion (IHP) is a procedure where the liver is surgically isolated and perfused with a high concentration of the chemotherapeutic agent melphalan. Briefly, the procedure starts with the setup of a percutaneous veno-venous bypass from the femoral vein to the external jugular vein. Via a laparotomy, catheters are then inserted into the proper hepatic artery and the caval vein. The portal vein and the caval vein, both supra- and infrahepatically, are then clamped. The arterial and venous catheters are connected to a heart lung machine and the liver is perfused with melphalan (1 mg/kg body weight) for 60 min. This way it is possible to locally perfuse the liver with a high dose of a chemotherapeutic agent, without leakage to the systemic circulation. In previous studies including patients with isolated liver metastases of uveal melanoma, an overall response rate of 33-100% and a median survival between 9 and 13 months, have been reported. The aim of this protocol is to give a clear description of how to perform the procedure and to discuss IHP as a treatment option for liver metastases of uveal melanoma.

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